Abstract: SA-PO070
The Multiple Faces of a Hepatitis C Donor
Session Information
- Transplantation: Recipient and Donor Assessment
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1802 Transplantation: Clinical
Authors
- Keceli, Cagla, The University of Chicago Booth School of Business, Chicago, Illinois, United States
- AbdulRahim, Nashila, UT Southwestern Medical Center, Dallas, Texas, United States
- Sandikci, Burhaneddin, The University of Chicago Booth School of Business, Chicago, Illinois, United States
- Zhong, Yuan, The University of Chicago Booth School of Business, Chicago, Illinois, United States
- La Hoz, Ricardo M., UT Southwestern Medical Center, Dallas, Texas, United States
- Tanriover, Bekir, UT Southwestern Medical Center, Dallas, Texas, United States
- Ariyamuthu, Venkatesh Kumar, UT Southwestern Medical Center, Dallas, Texas, United States
Background
Public Health Service (PHS) increased risk donors are on the rise in the US and provide an underutilized pool of organs. With the advent of a myriad of Hepatitis C treatment options, use of these organs has become an attractive option for select recipients. An updated list of characteristics of all PHS increased risk donors is presented here.
Methods
UNOS database was queried for all deceased donor kidneys retrieved between 4/1/2015 and 9/30/17. The study population was divided into four categories based on their hepatitis C antibody (Ab) and nucleic acid testing (NAT): Ab-/NAT-, Ab-/NAT+, Ab+/NAT-; Ab+/NAT+. Characteristics of age, gender, race, donation after cardiac death (DCD), PHS increased risk, BMI, diabetes, macrovesicular fat, and KDPI are investigated across the four donor categories.
Results
Mean age of Ab-/NAT- donors is slightly higher than Ab-/NAT+, Ab+/NAT+, and Ab+/NAT- donors; Ab-/NAT-, Ab+/NAT-, and Ab+/NAT+ donors are predominantly male. Region 2 has the highest number of donors with NAT and/or Ab + carrier status. Ab+/NAT- donors have the highest, mean KDPI of 54.1. Less than 10% of all deceased donors are diabetics. While 21% of Ab-NAT- donors were characterized as PHS increased risk, nearly 15% of NAT and/or Ab + carrier donors did not meet PHS criteria by definition.
Conclusion
Our data sheds light into characteristics of all deceased donors over a 2.5 year period. It questions the accuracy of screening criteria for PHS increased risk donors. Delineation of these features allows for identification of an underutilized organ pool for an appropriate kidney transplant recipient group.
Donor Characteristics
| Ab-/NAT- | Ab-/NAT+ | Ab+/NAT- | Ab+/NAT+ | p-value | |
| N | 28740 | 33 | 372 | 739 | |
| Age (mean years +/- standard deviation) | 37.9 ± 15.8 | 27.4 ± 8.4 | 35.2 ± 10.1 | 32.6 ± 8.2 | < 0.001 |
| Sex N (% male) | 17618 (61.3%) | 11 (33.3%) | 192 (51.6%) | 497 (67.3%) | < 0.001 |
| Black (%) Hispanic (%) Other (%) White (%) | 4054 (14.1) 3931 (13.7) 1312 (4.6) 19443 (67.7) | 1 (3.0) 3 (9.1) 0 (0) 29 (87.9) | 8 (2.2) 24 (64.5) 7 (1.9) 333 (89.5) | 24 (3.2) 74 (10.0) 15 (2.0) 626 (84.7) | < 0.001 |
| DCD N (%) | 6118 (21.3) | 2 (6.1) | 42 (11.3) | 59 (8.0) | < 0.001 |
| BMI (mean +/- standard deviation) | 27.95 ± 7.2 | 26.09 ± 6.6 | 27.45 ± 5.7 | 25.9 ± 4.9 | < 0.001 |
| Diabetes N (%) | 1977 (6.9) | 0 (0) | 7 (1.9) | 8 (1.1) | < 0.001 |
| Macrovesicular Fat of <= 40% N (%) | 7425 (25.8) | 18 (54.5) | 181 (48.7) | 431 (58.3) | < 0.001 |
| KDPI (mean) | 47.1 ± 26.5 | 20.8 ± 16.9 | 54.1 ± 17.8 | 48.6 ± 16.3 | < 0.001 |
| PHS N (%) | 6139 (21.4) | 28 (84.8) | 276 (74.2) | 616 (83.4) | < 0.001 |