Kidney Transplantation From Brain-Dead Donors With Hepatitis B or C in South Korea: A 2015 to 2020 Korean Organ Transplantation Registry Data Analysis

Abstract

Background: According to the current Center for Korean Network for Organ Sharing guidelines for kidney transplantation from brain-dead donors with hepatitis B or C infection, organs from hepatitis B surface antigen-positive (HbsAg⁺) or anti-hepatitis C virus-positive (HCV⁺) donors can only be transplanted into HBsAg⁺ or anti-HCV⁺ recipients. We aimed to confirm the status and the outcomes of kidney transplantation from brain-dead donors with hepatitis B or C virus in Korea.

Methods: This retrospective study included all kidney transplantations from brain-dead donors in the Korean Organ Transplantation Registry database between January 2015 and June 2020, divided into 3 groups according to donor hepatitis status. Finally, kidney transplantations from 80 HBV⁺, 12 HCV⁺, and 2013 HBV^-/HCV^- donors were included.

Results: No statistically significant differences were observed in the recipient characteristics and the transplant outcomes except the waiting time (HBV⁺ to HBV^-/HCV^-, P < .001; HCV⁺ to HBV^-/HCV^-, P = .10; HBV⁺ to HCV⁺P = .95). Five-year graft survival rates of the HBV⁺, HCV⁺, and HBV^-/HCV^- recipients were 95%, 83%, and 85%, respectively (HBV⁺ to HCV⁺, P = .22; HCV⁺ to HBV^-/HCV^-, P = .81; HBV⁺ to HBV^-/HCV^-, P = .02). Five-year patient survival rates of the HBV⁺, HCV⁺, and HBV^-/HCV^- recipients were 95%, 100%, and 76%, respectively (HBV⁺ to HCV⁺, P = .61; HCV⁺ to HBV^-/HCV^-, P = .13; HBV⁺ to HBV^-/HCV^-, P < .001).

Conclusion: HBV⁺/HCV⁺ brain-dead donor kidney transplantation outcomes were comparable to HBV^-/HCV^-. South Korea should consider conditionally permitting transplantation from HBV⁺ or HCV⁺ donors to HBV^- or HCV^- recipients to accumulate new data and conduct further studies.