Hepatitis C virus infection in kidney donors
- Marion Muche, MD
Marion Muche, MD
- Charité - Medical University, Berlin, Germany
- Brian JG Pereira, MD
Brian JG Pereira, MD
- Professor of Medicine
- Tufts University School of Medicine
- Seema Baid-Agrawal, MD
Seema Baid-Agrawal, MD
- Associate Professor of Medicine
- Sahlgrenska Medical University, Gothenburg, Sweden
- Section Editors
- Daniel C Brennan, MD, FACP
Daniel C Brennan, MD, FACP
- Editor-in-Chief — Nephrology
- Section Editor — Renal Transplantation
- Professor of Medicine
- Washington University School of Medicine
- Adrian M Di Bisceglie, MD
Adrian M Di Bisceglie, MD
- Section Editor — Hepatitis C
- Chief of Hepatology
- Saint Louis University School of Medicine
Transplantation of a kidney from a hepatitis C virus (HCV)-infected kidney donor may cause HCV infection in the recipient [1,2]. HCV infection has been associated with increased morbidity and possibly mortality in kidney transplant recipients [3-5].
These observations have led to the development of national and international policies concerning the allocation of organs from HCV-positive or negative donors into HCV-positive or negative recipients.
This topic reviews issues surrounding HCV-infected deceased or living kidney donors. HCV infection in kidney transplant recipients, transplant candidates, and nontransplant candidate dialysis patients is discussed elsewhere. (See "Renal disease associated with hepatitis C virus after renal transplantation" and "Hepatitis C virus infection in patients on maintenance dialysis".)
The prevalence of HCV infection in the general population is approximately 2 to 3 percent worldwide . The best data regarding prevalence among deceased organ donors are from a study of 13,667 potential organ donors evaluated between 2004 and 2008 by 17 organ procurement organizations in the United States; HCV prevalence was 3.45 percent among normal-risk potential donors and 18.20 percent among high-risk potential donors . In one study of 55 living, related potential donors, the prevalence of HCV was 3.6 percent .The reported prevalence of HCV infection among renal transplant recipients is approximately 1.8 to 8 percent [9-13]. (See "Renal disease associated with hepatitis C virus after renal transplantation".)
TRANSMISSION OF HCV INFECTION BY KIDNEY TRANSPLANTATION
The risk of transmission of HCV infection associated with organ transplantation from an HCV-positive donor is significant [1,14-18]. In two reports, among recipients of organs from anti-HCV-positive donors, 14 to 100 percent tested positive for anti-HCV antibodies after transplantation, and 57 to 96 percent tested positive for HCV RNA by polymerase chain reaction (PCR) [1,14].
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- Humar A, Morris M, Blumberg E, et al. Nucleic acid testing (NAT) of organ donors: is the 'best' test the right test? A consensus conference report. Am J Transplant 2010; 10:889.
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- Cruzado JM, Gil-Vernet S, Castellote J, et al. Successful treatment of chronic HCV infection should not preclude kidney donation to an HCV negative recipient. Am J Transplant 2013; 13:2773.
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- TRANSMISSION OF HCV INFECTION BY KIDNEY TRANSPLANTATION
- OUTCOMES OF TRANSPLANTATION OF HCV-POSITIVE KIDNEY
- Compared with HCV-negative kidneys
- Compared with waitlisted patients
- Among HCV-positive recipients
- IDENTIFICATION OF HCV INFECTION AMONG DONORS
- Deceased donors
- Living donors
- APPROACH TO THE USE OF KIDNEYS FROM DONORS WITH HCV INFECTION
- Deceased donors with HCV infection
- Living donors with HCV infection
- SUMMARY AND RECOMMENDATIONS