Shorter waitlist times and improved graft survivals are observed in patients who accept hepatitis C virus+ renal allografts.

Background: There is a paucity of data regarding long-term renal graft survival in hepatitis C virus positive (HCV+) patients. We analyzed our institution's experience with HCV+ renal transplantation and factors contributing to subsequent renal graft failure.

Methods: We analyzed 1,679 adult, deceased donor, single-organ renal transplants occurring between 2000 and 2012. Recipient and donor demographics, HCV serostatus, and graft outcome and function were evaluated.

Results: Of 1,679 patients, 195 HCV+ recipients (R+) received renal transplants from HCV+ donors (D+), in contrast to 1,418 HCV negative (HCV-) recipients (R-) who received grafts from HCV- donors (D-), and 66 R+ patients who received D- kidneys. Death-censored graft survival in the R+/D+ population was better than graft survival for R+/D- patients, despite R+/D+ patients having higher rates of hypertension and African Americans. Waitlist times for patients accepting HCV+ grafts was 318 days (for R+/D+ patients) versus 613 days (R-/D-) or 570 days (R+/D-). On multivariate analysis, waitlist times were independently predictive of graft failure.

Conclusions: R+/D+ patients spent less time on the transplant waitlist, which contributed to improved death censored graft survival when compared with R+/D- patients.