Kidney transplantation from brain-dead donors with hepatitis B or C in South Korea: a 2015-2020 korean organ transplantation registry data analysis

초록

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 HBsAg (+) or anti-HCV (+) donors can only be transplanted into HBsAg (+) or anti-HCV(+) recipients. We aimed to confirm the current status and kidney transplantation results from brain-dead donors with hepatitis B or C virus in Korea and to identify strategies for resolving donor-recipient disparity. 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 three groups according to donor hepatitis status. Finally, kidney transplantations from 80 HBV (+), 12 HCV(+), and 2,013 HBV(-)/HCV(-) donors were included. Results: No statistically significant differences were observed in the follow-up period, number of kidney transplants, postoperative hospital days, survival rate, serum creatinine from baseline to 5 years, cause of graft loss, complications, or rejection between the three groups. Five-year graft survival rates of the HBV (+), HCV (+), and HBV(-)/HCV (-) recipients were 95%, 83.3%, and 84.5%, respectively [HBV(+)-HCV(+), p = 0.22; HCV(+)-HBV(-)/HCV(-), p = 0.81; HBV(+)-HBV(-)/HCV(-), p = 0.02]. Five-year patient survival rates of the HBV(+), HCV(+), and HBV(-)/HCV(-) recipients were 95%, 100%, and 76.2%, respectively [HBV(+)-HCV(+), p = 0.61; HCV(+)-HBV(-)/HCV(-), p = 0.13; HBV(+)-HBV(-)/HCV(-), p < 0.001]. Conclusion: HBV(+)/HCV(+) brain-dead donor kidney transplantation outcomes were comparable to HBV(-)/HCV (-). Thus, South Korea can begin transplantation from HBV(+) or HCV(+) donors to HBV(-) or HCV(+) recipients as soon as possible, giving many patients hope.