Elderly recipients of hepatitis C positive renal allografts can quickly develop liver disease.

TitleElderly recipients of hepatitis C positive renal allografts can quickly develop liver disease.
Publication TypeJournal Article
Year of Publication2012
AuthorsFlohr TR, Bonatti H, Hranjec T, Keith DS, Lobo PI, Kumer SC, Schmitt TM, Sawyer RG, Pruett TL, Roberts JP, Brayman KL
JournalThe Journal of surgical research// J Surg Res
Volume176
Issue2
Pagination629 - 38
Date Published2012//
ISBN Number1095-8673
Other Numbersk7b, 0376340
Keywords*Hepatitis C/tm [Transmission], *Kidney Failure, Chronic/su [Surgery], *Kidney Transplantation/ae [Adverse Effects], *Postoperative Complications/vi [Virology], Adult, Age Factors, Aged, Female, Follow-Up Studies, Graft Rejection/dt [Drug Therapy], Graft Rejection/mo [Mortality], Graft Survival, Hepatitis C/mo [Mortality], Humans, Immunosuppressive Agents/tu [Therapeutic Use], Kaplan-Meier Estimate, Kidney Failure, Chronic/mo [Mortality], Male, Middle Aged, Morbidity, Postoperative Complications/mo [Mortality], Tissue Donors, Transplantation, Homologous, Young Adult
Abstract

Our institution explored using allografts from donors with Hepatitis C virus (HCV) for elderly renal transplantation (RT). Thirteen HCV- elderly recipients were transplanted with HCV+ allografts (eD+/R-) between January 2003 and April 2009. Ninety HCV- elderly recipients of HCV- allografts (eD-/R-), eight HCV+ recipients of HCV+ allografts (D+/R+) and thirteen HCV+ recipients of HCV- allografts (D-/R+) were also transplanted. Median follow-up was 1.5 (range 0.8-5) years. Seven eD+/R- developed a positive HCV viral load and six had elevated liver transaminases with evidence of hepatitis on biopsy. Overall, eD+/R- survival was 46% while the eD-/R- survival was 85% (P = 0.003). Seven eD+/R- died during follow-up. Causes included multi-organ failure and sepsis (n = 4), cancer (n = 1), failure-to-thrive (n = 1) and surgical complications (n = 1). One eD+/R- died from causes directly related to HCV infection. In conclusion, multiple eD+/R- quickly developed HCV-related liver disease and infections were a frequent cause of morbidity and mortality.Copyright © 2012 Elsevier Inc. All rights reserved.
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