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Clinical outcomes of hepatitis C treatment before and after kidney transplantation and its impact on time to transplant: A multicenter study
Author(s) -
Chascsa D. M.,
Mousa O. Y.,
Pungpapong S.,
Zhang N.,
Chervenak A.,
Nidamanuri S.,
Rodriguez E.,
Franco D.,
Ryland K.,
Keaveny A. P.,
Huskey J. L.,
Smith M.,
Reddy K. S.,
Taner C. B.,
Vargas H. E.,
Aqel B. A.
Publication year - 2018
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.14931
Subject(s) - medicine , transplantation , interquartile range , tolerability , hepatitis c , kidney transplantation , adverse effect , hepatitis b , kidney , surgery
Waitlist time for kidney transplantation is long but may be shortened with the utilization of hepatitis C positive allografts. We retrospectively reviewed the course of 36 hepatitis C positive patients awaiting kidney transplantation at 2 large centers within the same health system, with near‐identical care delivery models with the exception of timing of hepatitis C treatment, to determine the impact of timing of hepatitis C treatment on access to transplant, waitlist time, and treatment efficacy and tolerability. The majority of patients had hepatitis C genotype 1a or 1b, and all received direct acting antiviral therapy with 100% treatment response. One patient underwent transplantation in the pretransplant treatment group. The 1‐year transplantation rate was 12.5% vs 67.9% ( P = .0013) in those treated posttransplantation. The median waitlist time in the posttransplant group was 122 ( interquartile range [IQR] 21.5, 531.0) days, which was significantly shorter than the center’s regional and national wait time. Pathologic review revealed no difference in allograft quality. Overall treatment related adverse events were not different between the 2 groups. A strategy of posttransplant hepatitis C treatment increased access to transplant and reduced waitlist time. Delaying treatment until after transplant did not appear to adversely affect recipients’ kidney allograft or overall survival.