Transplantation of kidneys from hepatitis C-infected donors to hepatitis C-negative recipients: Single center experience

Am J Transplant. 2019 Nov;19(11):3046-3057. doi: 10.1111/ajt.15530. Epub 2019 Aug 2.


Our aim was to evaluate the safety of transplanting kidneys from HCV-infected donors in HCV-uninfected recipients. Data collected from 53 recipients in a single center, observational study included donor and recipient characteristics, liver and kidney graft function, new infections and de novo donor-specific antibodies and renal histology. Treatment with a direct-acting antiviral regimen was initiated when HCV RNA was detected. The mean ± SD age of recipients was 53 ± 11 years, 34% were female, 19% and 79% of recipients were white and African American, respectively. The median and interquartile range (IQR) time between transplant and treatment initiation was 76 (IQR: 68-88) days. All 53 recipients became viremic (genotype: 1a [N = 34], 1b [N = 1], 2 [N = 3], and 3 [N = 15]). The majority (81%) of recipients did not experience clinically significant increases (>3 times higher than upper limit of the normal value) in aminotransferase levels and their HCV RNA levels were in the 5 to 6 log range. One patient developed fibrosing cholestatic hepatitis with complete resolution. All recipients completed antiviral treatment and 100% were HCV RNA-negative and achieved 12-week sustained virologic response. The estimated GFRs at end of treatment and 12-week posttreatment were 67 ± 21 mL/min/1.73 m2 and 67 ± 17 mL/min/1.73 m2 , respectively. Four recipients developed acute rejection. Kidney transplantation from HCV-infected donors to HCV-negative recipients should be considered in all eligible patients.

Keywords: clinical research/practice; hepatitis C; infection and infectious agents - viral; kidney (allograft) function/dysfunction; kidney transplantation/nephrology.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Graft Survival*
  • Hepacivirus / isolation & purification
  • Hepatitis C / drug therapy
  • Hepatitis C / transmission*
  • Hepatitis C / virology
  • Humans
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / methods*
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Tissue Donors / supply & distribution*
  • Tissue and Organ Procurement / methods
  • Transplant Recipients / statistics & numerical data*


  • Antiviral Agents