SAT-090 Long-term outcome of renal grafts from HCV antibody-positive, RNA-nucleic acid test negative live donors transplanted in HCV negative recipients in genotype 4: single center experience

Abstract

Egypt reported the highest prevalence of HCV infection all over the world (14.7%). Over 90% of HCV in Egypt is of genotype 4. Organ shortage is one of the main problems facing transplantation programs specially in countries without legalized deceased donations program like Egypt. In our center, HCV positivity is the third cause of donor exclusion accounts for 13% of refused donors. Short term outcome had been reported in HCV negative (HCVAb-) recipients received HCV antibody positive, nucleic acid testing for RNA negative (Ab+NAT-) graft. But, long term outcomes still questionable. We evaluate the long-term graft outcome and virological status in 24 (HCVAb-) recipients received (Ab+NAT-) graft in period between 1995 and 2002. Our study includes 24 patients transplanted in period between November1995 and July 2002 in our center. The study group were compared to 200 patients age and sex-matched group which received HCVAb- grafts. The objective was to estimate the seroconversion of the study group by reviewing the results of post-transplantation NAT for RNA, graft function, graft survival and long term complications between both groups The study of 24 (15 males & 9 females) patients with median (range) age of 20.5 (10-48) years were followed up for median (range) 117.5 (1-230) months. HCV-RNA NAT was carried out post-transplantation at median (range) period of 109 (18-287) months. One patient had quick graft failure within 1 month who was not tested. None of 23 tested patients showed seroconversion post transplantation. Moreover, there were no statistically significant difference between the recipients of HCV Ab+NAT- grafts and the control group received HCV Ab- grafts regarding graft functions and survival at 1, 5 and 10 years of follow-up (Table 1). 6 cases (3%) of malignancy were reported in control group with only one case (4.2%) of hepatic lymphoma in the study group. Hepatic dysfunction and gastrointestinal problems were equal in both groups.Tabled 1Control GroupStudy GroupP-value1 years S. creatinine (mg/dl)1.2 (0.5-9)1.28 (0.6-2.6)0.865 years S. creatinine (mg/dl)1.4 (0.7-10)1.7 (0.9-5)0.454Last follow up, S. creatinine (mg/dl)1.9 (0.6-12)4.13 (0.8-11)0.351 year graft survival (%)97.595.80.785-year graft survival (%)85.587.50.7710-year graft survival (%)44.554.20.342 Open table in a new tab These data confirmed the safety of using HCV Ab+NAT-donors for HCV Ab- recipients with no evidence of transmission and accepted long term graft outcome and safety profile. This will significantly increase donor pool in a country with highest prevalence of HCV worldwide specially with the unavailability of deceased donor program.