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Abstract：
Background The use of kidney donors with hepatitis C virus (HCV) has been arising as a possibility to increase the donor pool. It encompasses both the use of donors with positive and negative viremia, particularly since the advent of direct antiviral agents that produce sustained virologic response. Methodology We conducted a retrospective observational study to describe the experience of our transplantation center in the use of HCV antibody-positive (HCV-Ab+) kidneys. Results We performed five transplants with HCV-Ab+ donors. The median age of kidney recipients was 63 (interquartile range (IQR) = 54-71) years, and 60% (n = 3) were males. Two recipients received a second transplant. The median dialysis vintage was 1,414 (IQR = 1,103-2,806) days. The induction immunosuppression protocol was basiliximab in most patients (60%, n = 3), and all received maintenance immunosuppression with tacrolimus, mycophenolate mofetil, and prednisolone. One of the recipients had a personal history of cured HCV infection. Seroconversion occurred in half of the remaining patients, which was sustained during the follow-up. None of the patients developed HCV viremia. At the end of follow-up, mean creatinine and proteinuria were 1.45 ± 1.12 mg/dL and 0.099 ± 0.045 g/g, respectively. We did not observe any rejection episodes, need for dialysis, or recipient\'s death. Conclusions Our work aligns with the current literature that advocates that the use of these donors is safe and cost-effective and can be an effective strategy for expanding the donor pool and augmenting the transplantation volume. Seroconversion is a known risk whose mechanisms are not entirely understood, although it does not appear to be related to a higher transmission risk.
摘要：
背景使用丙型肝炎病毒（HCV）的肾脏供体已经成为增加供体库的可能性。它包括使用阳性和阴性病毒血症的供体，特别是自产生持续病毒学应答的直接抗病毒药物出现以来。方法我们进行了一项回顾性观察研究，以描述我们的移植中心使用HCV抗体阳性（HCV-Ab）肾脏的经验。结果我们用HCV-Ab+供体进行了五次移植。受者的中位年龄为63岁（四分位距（IQR）=54-71岁），60％（n=3）为男性。两名接受者接受了第二次移植。透析年份中位数为1,414天（IQR=1,103-2,806天）。大多数患者的诱导免疫抑制方案是巴利昔单抗(60%，n=3),所有人都接受了他克莫司的维持免疫抑制，霉酚酸酯，和泼尼松龙。其中一名接受者有治愈的HCV感染的个人史。其余一半患者发生血清转换，这在后续行动中得到了持续。没有患者发生HCV病毒血症。在后续行动结束时，平均肌酐和蛋白尿为1.45±1.12mg/dL和0.099±0.045g/g，分别。我们没有观察到任何拒绝事件，需要透析,或接受者的死亡。结论我们的工作与当前文献一致，这些文献主张使用这些供体是安全且具有成本效益的，并且可以是扩大供体库和增加移植体积的有效策略。血清转化是一种已知的风险，其机制尚未完全了解，尽管它似乎与更高的传播风险无关。
