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Transpl Infect Dis ; 26(3): e14295, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38761060

ABSTRACT

BACKGROUND: Though the use of Hepatitis B viremic (HBV) donor kidneys may be a safe alternative to improve access to transplantation, there has not been wide acceptance of this practice. In this study, we determined the safety and effectiveness of HBV NAT (+) donor kidneys in a protocolized manner in an older adult population. METHODS: Over a 3-year period, 16 decreased donor kidney transplants were performed with HBV NAT+ kidneys. Recipients of HBV NAT+ kidneys were treated with entecavir started pre-operatively and continued for 52 weeks. RESULTS: HBV NAT+ kidneys were preferentially used in older (68 ± 5 vs. 64 ± 9 years; p = .01) recipients with less dialysis time (93.8% < 5 years vs. 67% <5 years; p = .03). In this cohort, 3/16 had detectable HBV PCR 1-week post-transplant, but all were negative at 9- and 12-months. Calculated estimated glomerular filtration rate (eGFR) was slightly decreased 12-months post-transplant. Post-transplant outcomes in an age-matched cohort showed no difference in rates of delayed graft function, readmission within 30 days, and graft loss or death within 6 months of transplant (p > .05). CONCLUSION: Transplants with HBV NAT+ donor kidneys in a pre-emptive treatment protocol allow for increased safe access to transplantation in older adult recipients with little or no dialysis time.


Subject(s)
Antiviral Agents , Glomerular Filtration Rate , Hepatitis B , Kidney Transplantation , Tissue Donors , Viremia , Humans , Kidney Transplantation/adverse effects , Male , Female , Aged , Middle Aged , Antiviral Agents/therapeutic use , Hepatitis B virus/drug effects , Guanine/analogs & derivatives , Guanine/therapeutic use , Graft Survival , Delayed Graft Function
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