THE LONG-TERM IMPACT OF HCV INFECTION IN RENAL ALLOGRAFT RECIPIENTS.

Abstract

64 We have previously reported the absence of an adverse impact of HCV infection on patient and graft survival following renal transplantation (KI 1994; 45:238). However, other centers have reported differing results such that the long-term consequence of HCV infection in kidney recipients remains uncertain. The current study is an extended analysis of our data in which many patients are well into the second post transplant decade. HCV testing was by EIA or RIBA with confirmatory PCR for HCV RNA in >50% of cases. Median follow-up was 117.5 mo. (range, 1-221) in the HCV infected group (n= 188) and 109 mo. (range, 1-215) in the HCV (-) cohort (n= 103). There were no differences in age, gender, organ source, PRA, ABDR MM or cold ischemia time between groups. The HCV (+) group had a longer pretransplant dialysis interval(p = 0.03) and a fewer number of diabetics (p = 0.02) than the HCV (-) group.TableAs seen above, HCV status had no impact on patient or graft survival in a logistic regression model. Ten-year patient and graft survival in the HCV (+) group was 79% and 51% vs. 77% and 70% in the HCV (-) cohort (RR = 0.93 [95% CI, 0.55-1.5, p = NS] and RR = 1.4 [95% CI, 0.87-2.2, p = NS, for patient and graft survival in the HCV (+) and HCV (-) groups, respectively). HCV-infected patients had significantly more rejection events (p <.005) but an equal number of serious infectious episodes as the HCV (-) group. In summary, HCV infection does not independently affect patient or graft survival and our data does not demonstrate a compromise in long-term outcome in HCV-infected renal allograft recipients.