{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T19:57:24Z","timestamp":1786132644903,"version":"build-2736575974"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","funder":[{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["234-2005-370011C"],"award-info":[{"award-number":["234-2005-370011C"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JASN"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Significance Statement<\/jats:title>\n                    <jats:p>HCV-viremic kidneys are assessed as worse quality using the kidney donor profile index, which has led to many of these organs being discarded. Until 2015, HCV-viremic kidneys were almost exclusively transplanted into recipients with preexisting HCV infection. Since the advent of direct-acting HCV treatments, small trials of transplanting HCV-viremic kidneys into recipients without HCV and then treating them have had positive results. Using United States registry data, the authors show that there has been a dramatic increase in the transplantation of HCV-viremic kidneys into recipients without HCV infection since 2015. They also show that HCV-viremic kidney recipients have excellent kidney function at 12-months post-transplant. Yet, many HCV-viremic kidneys are still being discarded. In summary, kidneys from donors with HCV viremia function well despite adverse quality assessment and are a valuable resource for transplant candidates with or without HCV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Recent pilot trials have demonstrated the safety of transplanting HCV-viremic kidneys into HCV-seronegative recipients. However, it remains unclear if allograft function is impacted by donor HCV-viremia or recipient HCV-serostatus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used national United States registry data to examine trends in HCV-viremic kidney use between 4\/1\/2015 and 3\/31\/2019. We applied advanced matching methods to compare eGFR for similar kidneys transplanted into highly similar recipients of kidney transplants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over time, HCV-seronegative recipients received a rising proportion of HCV-viremic kidneys. During the first quarter of 2019, 200 HCV-viremic kidneys were transplanted into HCV-seronegative recipients, versus 69 into HCV-seropositive recipients, while 105 HCV-viremic kidneys were discarded. The probability of HCV-viremic kidney discard has declined over time. Kidney transplant candidates willing to accept a HCV-seropositive kidney increased from 2936 to 16,809 from during this time period. When transplanted into HCV-seronegative recipients, HCV-viremic kidneys matched to HCV-non-viremic kidneys on predictors of organ quality, except HCV, had similar 1-year eGFR (66.3 versus 67.1 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.86). This was despite the much worse kidney donor profile index scores assigned to the HCV-viremic kidneys. Recipient HCV-serostatus was not associated with a clinically meaningful difference in 1-year eGFR (66.5 versus 71.1 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.056) after transplantation of HCV-viremic kidneys.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>By 2019, HCV-seronegative patients received the majority of kidneys transplanted from HCV-viremic donors. Widely used organ quality scores underestimated the quality of HCV-viremic kidneys based on 1-year allograft function. Recipient HCV-serostatus was also not associated with worse short-term allograft function using HCV-viremic kidneys.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1681\/asn.2019050462","type":"journal-article","created":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T14:25:13Z","timestamp":1568298313000},"page":"1939-1951","source":"Crossref","is-referenced-by-count":74,"title":["National Trends in Utilization and 1-Year Outcomes with Transplantation of HCV-Viremic Kidneys"],"prefix":"10.1681","volume":"30","author":[{"given":"Vishnu S.","family":"Potluri","sequence":"first","affiliation":[{"name":"Renal-Electrolyte and Hypertension Division, Department of Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Departments of Biostatistics, Epidemiology and Bioinformatics and"},{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5305-9685","authenticated-orcid":false,"given":"Sumit","family":"Mohan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Vagelos College of Physicians and Surgeons and"},{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4783-7775","authenticated-orcid":false,"given":"Roy D.","family":"Bloom","sequence":"additional","affiliation":[{"name":"Renal-Electrolyte and Hypertension Division, Department of Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deirdre","family":"Sawinski","sequence":"additional","affiliation":[{"name":"Renal-Electrolyte and Hypertension Division, Department of Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter L.","family":"Abt","sequence":"additional","affiliation":[{"name":"Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily A.","family":"Blumberg","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chirag R.","family":"Parikh","sequence":"additional","affiliation":[{"name":"Renal Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Sharpe","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. Rajender","family":"Reddy","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9665-330X","authenticated-orcid":false,"given":"Miklos Z.","family":"Molnar","sequence":"additional","affiliation":[{"name":"James D. Eason Transplant Institute, Methodist University Hospital, Memphis, Tennessee;"},{"name":"Department of Surgery and Medicine, Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Sise","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter P.","family":"Reese","sequence":"additional","affiliation":[{"name":"Renal-Electrolyte and Hypertension Division, Department of Medicine,"},{"name":"Departments of Biostatistics, Epidemiology and Bioinformatics and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,9,12]]},"reference":[{"key":"B1-20231016","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1056\/NEJMp1505074","article-title":"Transplanting hepatitis C-positive kidneys.","volume":"373","author":"Reese","year":"2015","journal-title":"N Engl J Med"},{"key":"B2-20231016","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1111\/jvh.12148","article-title":"Meta-analysis of observational studies: Hepatitis C and survival after renal transplant.","volume":"21","author":"Fabrizi","year":"2014","journal-title":"J Viral Hepat"},{"key":"B3-20231016","doi-asserted-by":"crossref","first-page":"2088","DOI":"10.1097\/TP.0000000000002323","article-title":"Changes in utilization and discard of HCV antibody-positive deceased donor kidneys in the era of direct-acting antiviral therapy.","volume":"102","author":"Bowring","year":"2018","journal-title":"Transplantation"},{"key":"B4-20231016","doi-asserted-by":"crossref","first-page":"2473","DOI":"10.1111\/ajt.14895","article-title":"The impact of direct-acting antiviral agents on liver and kidney transplant costs and outcomes.","volume":"18","author":"Axelrod","year":"2018","journal-title":"Am J Transplant"},{"key":"B5-20231016","doi-asserted-by":"crossref","first-page":"2453","DOI":"10.1111\/j.1600-6143.2010.03280.x","article-title":"Long-term experience with kidney transplantation from hepatitis C-positive donors into hepatitis C-positive recipients.","volume":"10","author":"Morales","year":"2010","journal-title":"Am J Transplant"},{"key":"B6-20231016","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.kint.2018.02.016","article-title":"Factors leading to the discard of deceased donor kidneys in the United States.","volume":"94","author":"Mohan","year":"2018","journal-title":"Kidney Int"},{"key":"B8-20231016","doi-asserted-by":"crossref","first-page":"273","DOI":"10.7326\/M18-0749","article-title":"Twelve-month outcomes after transplant of hepatitis C-infected kidneys into uninfected recipients: A single-group trial.","volume":"169","author":"Reese","year":"2018","journal-title":"Ann Intern Med"},{"key":"B9-20231016","doi-asserted-by":"crossref","first-page":"663","DOI":"10.12659\/AOT.905428","article-title":"Is kidney donor profile index (KDPI) valid for hepatitis C aviremic kidneys?","volume":"22","author":"Sibulesky","year":"2017","journal-title":"Ann Transplant"},{"key":"B10-20231016","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1111\/ajt.14701","article-title":"Are we underestimating the quality of aviremic hepatitis C-positive kidneys? 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