Hepatitis C virus infection and kidney transplantation

Predictors of patient and graft survival

Daniel Maluf, Robert A. Fisher, Anne L. King, Eric M. Gibney, Valeria Mas, Adrian H. Cotterell, Mitchell L. Shiffman, Richard K. Sterling, Martha Behnke, Marc P. Posner

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

BACKGROUND. The effect of hepatitis C virus (HCV) infection on patients undergoing kidney transplantation (KTx) is uncertain. This study aimed to evaluate the outcomes of our HCV+/end-stage renal disease (ESRD) patient population based on the therapeutic option including KTx or continuation in dialysis. METHODS. KTx performed at Virginia Commonwealth University Hospital between January 2000 and December 2004 were tracked prospectively. Forty-three out of a total of 394 KTx patients included in the analysis were HCV+. A group of 52 contemporaneous HCV+/ESRD patients listed, but never transplanted, was also analyzed. HCV-negative transplanted patients were used as the control group. RESULTS. Patient survival posttransplantation was 81.4% and 68.5% at 1 and 3 years in the HCV+ group, and 97.1% and 92.9% at 1 and 3 years in the HCV- group, respectively (P=0.001). Graft survival was 81.2% and 64.1% at 1 and 3 years in the HCV+ group, and 93.2% and 84.1% at 1 and 3 years posttransplantation in the HCV- group (P=0.01). Univariate analysis identified Knodell score as a predictor of mortality in HCV+ patients (P=0.04). Cox proportional hazards multivariate analysis identified deceased donor (P=0.02), previous kidney transplant (P=0.007), pretransplant diabetes (P=0.05), and Knodell Score (P=0.012) as predictors of patient mortality. Patient survival was superior in HCV+ patients undergoing KTx versus remaining on dialysis. CONCLUSIONS. Patients with ESRD/HCV+ benefit from KTx without achieving the excellent survival of HCV-/ESRD patients. Liver biopsy is a useful tool to identify advanced liver disease at pretransplantation time.

Original languageEnglish (US)
Pages (from-to)853-857
Number of pages5
JournalTransplantation
Volume83
Issue number7
DOIs
StatePublished - Apr 1 2007
Externally publishedYes

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Graft Survival
Virus Diseases
Hepacivirus
Kidney Transplantation
Chronic Kidney Failure
Survival
Dialysis
Mortality
Liver Diseases
Multivariate Analysis
Tissue Donors

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Hepatitis C virus infection and kidney transplantation : Predictors of patient and graft survival. / Maluf, Daniel; Fisher, Robert A.; King, Anne L.; Gibney, Eric M.; Mas, Valeria; Cotterell, Adrian H.; Shiffman, Mitchell L.; Sterling, Richard K.; Behnke, Martha; Posner, Marc P.

In: Transplantation, Vol. 83, No. 7, 01.04.2007, p. 853-857.

Research output: Contribution to journalArticle

Maluf, D, Fisher, RA, King, AL, Gibney, EM, Mas, V, Cotterell, AH, Shiffman, ML, Sterling, RK, Behnke, M & Posner, MP 2007, 'Hepatitis C virus infection and kidney transplantation: Predictors of patient and graft survival', Transplantation, vol. 83, no. 7, pp. 853-857. https://doi.org/10.1097/01.tp.0000259725.96694.0a
Maluf, Daniel ; Fisher, Robert A. ; King, Anne L. ; Gibney, Eric M. ; Mas, Valeria ; Cotterell, Adrian H. ; Shiffman, Mitchell L. ; Sterling, Richard K. ; Behnke, Martha ; Posner, Marc P. / Hepatitis C virus infection and kidney transplantation : Predictors of patient and graft survival. In: Transplantation. 2007 ; Vol. 83, No. 7. pp. 853-857.
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abstract = "BACKGROUND. The effect of hepatitis C virus (HCV) infection on patients undergoing kidney transplantation (KTx) is uncertain. This study aimed to evaluate the outcomes of our HCV+/end-stage renal disease (ESRD) patient population based on the therapeutic option including KTx or continuation in dialysis. METHODS. KTx performed at Virginia Commonwealth University Hospital between January 2000 and December 2004 were tracked prospectively. Forty-three out of a total of 394 KTx patients included in the analysis were HCV+. A group of 52 contemporaneous HCV+/ESRD patients listed, but never transplanted, was also analyzed. HCV-negative transplanted patients were used as the control group. RESULTS. Patient survival posttransplantation was 81.4{\%} and 68.5{\%} at 1 and 3 years in the HCV+ group, and 97.1{\%} and 92.9{\%} at 1 and 3 years in the HCV- group, respectively (P=0.001). Graft survival was 81.2{\%} and 64.1{\%} at 1 and 3 years in the HCV+ group, and 93.2{\%} and 84.1{\%} at 1 and 3 years posttransplantation in the HCV- group (P=0.01). Univariate analysis identified Knodell score as a predictor of mortality in HCV+ patients (P=0.04). Cox proportional hazards multivariate analysis identified deceased donor (P=0.02), previous kidney transplant (P=0.007), pretransplant diabetes (P=0.05), and Knodell Score (P=0.012) as predictors of patient mortality. Patient survival was superior in HCV+ patients undergoing KTx versus remaining on dialysis. CONCLUSIONS. Patients with ESRD/HCV+ benefit from KTx without achieving the excellent survival of HCV-/ESRD patients. Liver biopsy is a useful tool to identify advanced liver disease at pretransplantation time.",
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T2 - Predictors of patient and graft survival

AU - Maluf, Daniel

AU - Fisher, Robert A.

AU - King, Anne L.

AU - Gibney, Eric M.

AU - Mas, Valeria

AU - Cotterell, Adrian H.

AU - Shiffman, Mitchell L.

AU - Sterling, Richard K.

AU - Behnke, Martha

AU - Posner, Marc P.

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N2 - BACKGROUND. The effect of hepatitis C virus (HCV) infection on patients undergoing kidney transplantation (KTx) is uncertain. This study aimed to evaluate the outcomes of our HCV+/end-stage renal disease (ESRD) patient population based on the therapeutic option including KTx or continuation in dialysis. METHODS. KTx performed at Virginia Commonwealth University Hospital between January 2000 and December 2004 were tracked prospectively. Forty-three out of a total of 394 KTx patients included in the analysis were HCV+. A group of 52 contemporaneous HCV+/ESRD patients listed, but never transplanted, was also analyzed. HCV-negative transplanted patients were used as the control group. RESULTS. Patient survival posttransplantation was 81.4% and 68.5% at 1 and 3 years in the HCV+ group, and 97.1% and 92.9% at 1 and 3 years in the HCV- group, respectively (P=0.001). Graft survival was 81.2% and 64.1% at 1 and 3 years in the HCV+ group, and 93.2% and 84.1% at 1 and 3 years posttransplantation in the HCV- group (P=0.01). Univariate analysis identified Knodell score as a predictor of mortality in HCV+ patients (P=0.04). Cox proportional hazards multivariate analysis identified deceased donor (P=0.02), previous kidney transplant (P=0.007), pretransplant diabetes (P=0.05), and Knodell Score (P=0.012) as predictors of patient mortality. Patient survival was superior in HCV+ patients undergoing KTx versus remaining on dialysis. CONCLUSIONS. Patients with ESRD/HCV+ benefit from KTx without achieving the excellent survival of HCV-/ESRD patients. Liver biopsy is a useful tool to identify advanced liver disease at pretransplantation time.

AB - BACKGROUND. The effect of hepatitis C virus (HCV) infection on patients undergoing kidney transplantation (KTx) is uncertain. This study aimed to evaluate the outcomes of our HCV+/end-stage renal disease (ESRD) patient population based on the therapeutic option including KTx or continuation in dialysis. METHODS. KTx performed at Virginia Commonwealth University Hospital between January 2000 and December 2004 were tracked prospectively. Forty-three out of a total of 394 KTx patients included in the analysis were HCV+. A group of 52 contemporaneous HCV+/ESRD patients listed, but never transplanted, was also analyzed. HCV-negative transplanted patients were used as the control group. RESULTS. Patient survival posttransplantation was 81.4% and 68.5% at 1 and 3 years in the HCV+ group, and 97.1% and 92.9% at 1 and 3 years in the HCV- group, respectively (P=0.001). Graft survival was 81.2% and 64.1% at 1 and 3 years in the HCV+ group, and 93.2% and 84.1% at 1 and 3 years posttransplantation in the HCV- group (P=0.01). Univariate analysis identified Knodell score as a predictor of mortality in HCV+ patients (P=0.04). Cox proportional hazards multivariate analysis identified deceased donor (P=0.02), previous kidney transplant (P=0.007), pretransplant diabetes (P=0.05), and Knodell Score (P=0.012) as predictors of patient mortality. Patient survival was superior in HCV+ patients undergoing KTx versus remaining on dialysis. CONCLUSIONS. Patients with ESRD/HCV+ benefit from KTx without achieving the excellent survival of HCV-/ESRD patients. Liver biopsy is a useful tool to identify advanced liver disease at pretransplantation time.

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