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Diseases 2018, 6(3), 62; https://doi.org/10.3390/diseases6030062

Underutilization of Hepatitis C Virus Seropositive Donor Kidneys in the United States in the Current Opioid Epidemic and Direct-Acting Antiviral Era

1
Department of Medicine, Stanford University School of Medicine, Palo Alto, CA 94304, USA
2
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CA 94304, USA
3
Division of Nephrology, Stanford University School of Medicine, Palo Alto, CA 94304, USA
4
United Network for Organ Sharing, Richmond, VA 23219, USA
5
Department of Transplant Surgery, Methodist University Hospital, University of Tennessee Health Science Center, Memphis, TN 38104, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Tatsuo Kanda
Received: 14 June 2018 / Revised: 5 July 2018 / Accepted: 9 July 2018 / Published: 10 July 2018
(This article belongs to the Special Issue Hepatitis and Treatment)
Full-Text   |   PDF [816 KB, uploaded 10 July 2018]   |  

Abstract

In recent years, the opioid epidemic and new hepatitis C virus (HCV) treatments have changed the landscape of organ procurement and allocation. We studied national trends in solid organ transplantation (2000–2016), focusing on graft utilization from HCV seropositive deceased donors in the pre-2014 (2000–2013) versus current (2014–2016) eras with a retrospective analysis of the United Network for Organ Sharing database. During the study period, HCV seropositive donors increased from 181 to 661 donors/year. The rate of HCV seropositive donor transplants doubled from 2014 to 2016. Heart and lung transplantation data were too few to analyze. A higher number of HCV seropositive livers were transplanted into HCV seropositive recipients during the current era: 374 versus 124 liver transplants/year. Utilization rates for liver transplantation reached parity between HCV seropositive and non-HCV donors. While the number of HCV seropositive kidneys transplanted to HCV seropositive recipients increased from 165.4 to 334.7 kidneys/year from the pre-2014 era to the current era, utilization rates for kidneys remained lower in HCV seropositive than in non-HCV donors. In conclusion, relative underutilization of kidneys from HCV seropositive versus non-HCV donors has persisted, in contrast to trends in liver transplantation. View Full-Text
Keywords: hepatitis C virus; kidney transplantation; drug overdose; organ utilization; direct-acting antiviral agents hepatitis C virus; kidney transplantation; drug overdose; organ utilization; direct-acting antiviral agents
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Li, A.A.; Cholankeril, G.; Cheng, X.S.; Tan, J.C.; Kim, D.; Toll, A.E.; Nair, S.; Ahmed, A. Underutilization of Hepatitis C Virus Seropositive Donor Kidneys in the United States in the Current Opioid Epidemic and Direct-Acting Antiviral Era. Diseases 2018, 6, 62.

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