Transplantation reviews (Orlando, Fla.) · 2026
Meta-analysis of the impact of donor hepatitis C infection on kidney transplantation outcomes.
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Dermanis Alexander A, Thompson Dominic, Koimtzis Georgios
Аннотация
INTRODUCTION: Kidney transplantation is the intervention of choice for patients with end-stage renal disease. The advent of direct acting antiviral (DAA) medication has changed the management of hepatitis C virus (HCV), which has led to some centres expand donation criteria to include HCV-positive donors. This study aims to assess the influence of donor HCV status on post-transplantation outcomes.
METHODS: A PRISMA-compliant, systematic search of PubMed, EMBASE, Cochrane and Web of Science databases was performed. Studies comparing outcomes of recipients of HCV-positive versus HCV-negative donor kidneys were included. Outcomes included graft function, survival, acute rejection and delayed graft function. Subgroup analysis was performed stratifying studies by era, recipient HCV status and the presence of viraemia.
RESULTS: The systematic search identified 1461 studies which after evaluation led to the inclusion of 31 studies, with a total of 133,788 patients of whom 11,663 patients received HCV-positive donor kidneys and 122,125 received HCV-negative donor kidneys. There was a higher eGFR at 6-months for recipients of HCV-positive kidneys (MD 3.57, 95%CI: 1.68 to 5.47, p = 0.0002). No significant difference was observed between either group for all other outcomes. The subgroup analysis did not show worse outcomes for receiving a kidney from a viraemic donor or for HCV-negative recipients of HCV-positive kidneys.
CONCLUSION: This meta-analysis of the best available evidence demonstrates comparable outcomes for recipients of kidneys from HCV-positive donors. Provided the availability of DAA treatment, we recommend other centres expand their donation criteria to include HCV-positive donors.
METHODS: A PRISMA-compliant, systematic search of PubMed, EMBASE, Cochrane and Web of Science databases was performed. Studies comparing outcomes of recipients of HCV-positive versus HCV-negative donor kidneys were included. Outcomes included graft function, survival, acute rejection and delayed graft function. Subgroup analysis was performed stratifying studies by era, recipient HCV status and the presence of viraemia.
RESULTS: The systematic search identified 1461 studies which after evaluation led to the inclusion of 31 studies, with a total of 133,788 patients of whom 11,663 patients received HCV-positive donor kidneys and 122,125 received HCV-negative donor kidneys. There was a higher eGFR at 6-months for recipients of HCV-positive kidneys (MD 3.57, 95%CI: 1.68 to 5.47, p = 0.0002). No significant difference was observed between either group for all other outcomes. The subgroup analysis did not show worse outcomes for receiving a kidney from a viraemic donor or for HCV-negative recipients of HCV-positive kidneys.
CONCLUSION: This meta-analysis of the best available evidence demonstrates comparable outcomes for recipients of kidneys from HCV-positive donors. Provided the availability of DAA treatment, we recommend other centres expand their donation criteria to include HCV-positive donors.