More than half of donor kidneys in the United State infected with hepatitis C are thrown away, despite the need among hepatitis C patients who may die waiting for an infection-free organ, Johns Hopkins research suggests.
In a study of national data published online in the American Journal of Transplantation, the researchers say that while outcomes are slightly worse when hepatitis C-positive patients receive hepatitis C-positive organs, the advantages of more timely transplants may outweigh the risk of waiting perhaps more than year for a hepatitis C-negative kidney.
Patients with hepatitis C-positive make up about 12 percent of the population with kidney failure, and those patients have an increased risk of death on dialysis compared with those without the virus, the study says.
"Nationwide, kidneys from infected donors are inappropriately thrown out and denied to patients in need," says transplant surgeon Dorry L. Segev, an associate professor of surgery at the Johns Hopkins University School of Medicine and the study's leader. "Many transplant centers don't use these kidneys at all, effectively consigning hepatitis C-positive patients to an average unnecessary wait of a year longer for an uninfected organ."
That, he says, "means an extra year on dialysis, in which the risk of death is 10 to 15 percent."
The use of hepatitis C-positive kidneys has been controversial in the past, owing in part to a 1 percent difference in one-year survival for patients who receive the infected kidneys and a 2 percent difference in three-year survival. Segev says this difference "is easily made up for by getting off dialysis sooner."
Hepatitis C-positive kidneys rarely go to hepatitis C-negative patients because the organ would infect the recipient with the chronic liver disease.
In looking at data from more than 93,000 deceased kidney donors between 1995 and 2009, Segev and his colleagues found that hepa
|Contact: Stephanie Desmon|
Johns Hopkins Medical Institutions