Donor hepatitis C antibody positivity misclassifies kidney donor profile index in non-hepatitis C-infected donors: time to revise the kidney donor profile index – a retrospective cohort study
Masahiko Yazawa
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
Divison of Nephrology and Hypertension, St. Marianna University School of Medicine, Tokyo, Japan
These authors contributed equally.
Search for more papers by this authorVasanthi Balaraman
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
These authors contributed equally.
Search for more papers by this authorMakoto Tsujita
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
Search for more papers by this authorAmbreen Azhar
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
Search for more papers by this authorManish Talwar
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
Search for more papers by this authorAnshul Bhalla
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
Search for more papers by this authorPraveen K. Potukuchi
Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
IHOP, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, USA
Search for more papers by this authorJames D. Eason
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
Search for more papers by this authorCsaba P. Kovesdy
Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
Nephrology Section, Memphis VA Medical Center, Memphis, TN, USA
Search for more papers by this authorCorresponding Author
Miklos Z. Molnar
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
Correspondence
Miklos Z. Molnar MD, PhD, FEBTM, FERA, FASN, James D. Eason Transplant Institute, Methodist University Hospital, University of Tennessee Health Science Center, 1211 Union Ave, Memphis, TN 38104, USA.
e-mail: [email protected]
Search for more papers by this authorMasahiko Yazawa
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
Divison of Nephrology and Hypertension, St. Marianna University School of Medicine, Tokyo, Japan
These authors contributed equally.
Search for more papers by this authorVasanthi Balaraman
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
These authors contributed equally.
Search for more papers by this authorMakoto Tsujita
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
Search for more papers by this authorAmbreen Azhar
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
Search for more papers by this authorManish Talwar
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
Search for more papers by this authorAnshul Bhalla
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
Search for more papers by this authorPraveen K. Potukuchi
Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
IHOP, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, USA
Search for more papers by this authorJames D. Eason
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
Search for more papers by this authorCsaba P. Kovesdy
Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
Nephrology Section, Memphis VA Medical Center, Memphis, TN, USA
Search for more papers by this authorCorresponding Author
Miklos Z. Molnar
James D. Eason Transplant Institute, Methodist University Hospital, Memphis, TN, USA
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
Correspondence
Miklos Z. Molnar MD, PhD, FEBTM, FERA, FASN, James D. Eason Transplant Institute, Methodist University Hospital, University of Tennessee Health Science Center, 1211 Union Ave, Memphis, TN 38104, USA.
e-mail: [email protected]
Search for more papers by this authorSummary
The kidney donor profile index (KDPI) defines an hepatitis C (HCV) positive donor based on HCV antibody (Ab) and/or nucleic acid amplification test (NAT) positivity, with donors who are not actively infected (Ab+/NAT−) also classified as HCV positive. From Scientific Registry of Transplant Recipients dataset, we identified HCV-negative recipients, who received a kidney transplant from HCV Ab+/NAT− (n = 116) and HCV Ab−/NAT− (n = 25 574) donor kidneys. We then compared recipients’ estimated glomerular filtration rate (eGFR) at 6 months in matched cohorts, using combined exact matching (based on KDPI) and propensity score matching. We created two separate matched cohorts: for the first cohort, we used the allocation KDPI, while for the second cohort we used an optimal KDPI, where the HCV component of KDPI was considered negative in Ab+/NAT− patients. The mean ± SD age of the allocation KDPI-matched cohort at baseline was 59 ± 10 years, 69% were male, 61% were white. Recipients’ eGFR at 6 months after transplantation was significantly higher in the HCV Ab+/NAT− group compared to the HCV Ab−/NAT− group (61.1 ± 17.9 vs. 55.6 ± 18.8 ml/min/1.73 m2, P = 0.011) in the allocation KDPI-matched cohort, while it was similar (61.8 ± 19.5 vs. 62.1 ± 20.1 ml/min/1.73 m2, P = 0.9) in the optimal KDPI-matched cohort. Recipients who received HCV Ab positive, but NAT-negative donor kidneys did not experience worse 6-month eGFR than correctly matched HCV Ab−/NAT− recipients.
Conflict of interest
The authors have declared no conflicts of interest.
Supporting Information
| Filename | Description |
|---|---|
| tri13743-sup-0001-SupInfo.docxWord document, 30.2 KB |
Figure S1. Histogram of propensity score in a matched population based on UNOS allocation KDPI (Panel a) and optimal KDPI (Panel b). Table S1. Baseline characteristics of included and excluded HCV antibody negative kidney transplant recipients who received a kidney allograft from an HCV NAT negative deceased donor between April 1st, 2015 and March 2nd, 2018. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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