Kidney Week

Abstract: SA-PO988

Trends in Discard of Kidneys from Hepatitis C Viremic Donors in the United States, 2020-2023

Session Information

• Transplantation: Clinical - 3
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Chauhan, Krutika P., Washington University in St Louis, St Louis, Missouri, United States

Krutika P. Chauhan, MBBS, MPH

• Chang, Su-Hsin, Washington University in St Louis, St Louis, Missouri, United States

Su-Hsin Chang, PhD

• Sutcliffe, Siobhan, Washington University in St Louis, St Louis, Missouri, United States

Siobhan Sutcliffe, MHS, PhD, ScM

• Merzkani, Massini, Washington University in St Louis, St Louis, Missouri, United States

Massini Merzkani, MD, MS

• Lentine, Krista L., Saint Louis University, St Louis, Missouri, United States

Krista L. Lentine, MD, PhD, FASN

• Tanriover, Bekir, The University of Arizona College of Medicine Tucson, Tucson, Arizona, United States

Bekir Tanriover, MD, MBA, MPH

• Alrata, Louai, Washington University in St Louis, St Louis, Missouri, United States

Louai Alrata, MD

• Yaseen Alsabbagh, Dema, Washington University in St Louis, St Louis, Missouri, United States

Dema Yaseen Alsabbagh, MD

• Alhamad, Tarek, Washington University in St Louis, St Louis, Missouri, United States

Tarek Alhamad, MD, MBA, MPH, FASN

Background

With the introduction of direct-acting antiviral (DAA), the discard rate of hepatitis C viremic (HCV) has decreased remarkably. With the continuous shortage of organs and the change in the allocation system, it is not clear if the HCV organs continue to have a higher risk of discard in the new era 2020 – 2023.

Methods

We used the 2020-2023 Organ Procurement and Transplantation Network (OPTN) to identify deceased donor kidneys recovered for transplant. We utilized our inclusion-exclusion criteria (Fig 1) to formulate our analytic cohort. The exposure was donor HCV antibody and viremia status. We did a multivariable logistic regression throughout the years to assess the association of HCV and discard while adjusting for donor characteristics. We also did another model where we adjusted for the COVID status of donors along with donor characteristics.

Results

Among the 101,088 kidneys recovered from 2020-2023, 5,718 (5.7%) were HCV viremic donors ( NAT+) and 4,768 (4.7%) were aviremic seropositive (NAT-, Ab+) donors. Compared to HCV aviremic seronegative kidneys (NAT-, Ab-), the odds of HCV viremic kidney discard slightly increased from 27% in 2020 (aOR 1.27, 95% CI, 1.07 to 1.51), to 33% in 2022 (aOR 1.33, 95% CI, 1.31 to 1.57). The results were not significant for 2021 and 2023 (2021, aOR 1.06; 95% CI, 1.31 to 1.57, and 2023, aOR 0.99; 95% CI, 0.83 to 1.18). (Figure 1A). We saw a similar trend when we adjusted for donor COVID status (Figure 1B). Kidneys from aviremic seropositive donors did not carry a higher risk of discard during the entire period.

Conclusion

Discard of HCV viremic kidneys has been fluctuating in the last few years with odds of 30% in 2020 and 2022 while not significant in the other years. With the prevalent organ shortage and safety of DAA, more efforts are needed to eliminate the discard of HCV viremic kidneys.