Kidney transplant from hepatitis C viremic donors into aviremic recipients and risk for post‐transplant BK and CMV infection

Background kidney transplantation from Hepatitis C virus (HCV) viremic donors to uninfected recipients is associated with excellent short‐term outcomes. However, HCV viremia might be associated with an increased risk for post‐transplant viral complications. Methods We designed a retrospective study of HCV‐negative kidney‐only transplant recipients between 2018 and 2020. Recipients were grouped into group 1; HCV‐negative donors, and group 2; HCV‐viremic donors. Patients were matched 1:1 using propensity score. The primary objectives were to compare the incidence of cytomegalovirus (CMV) viremia ≥ 200 ml/IU, and BK viremia ≥1000 copies/ml between the groups. Secondary outcomes included group comparison of CMV disease, BK viremia ≥10 000 copies/ml, and 1‐year patient and allograft survival. Results The study included 634 patients in group 1, and 71 patients in group 2. Sixty‐five pairs of patients were matched. Incidence of CMV viremia (33.3% vs. 40.0%, p = .4675), and BK viremia (15.9% vs. 27.7%, p = .1353) did not differ significantly between groups in the matched cohort. Incidence of CMV disease (81.0% vs. 76.9%, p = 1.000), and BK viremia ≥10 000 copies/ml (9.5% vs. 16.9%, p = .2987) were comparable between groups. There was no difference in the 1‐year patient or allograft survival between groups. Conclusion kidney transplant from HCV‐viremic donors is not associated with increased risk for BK or CMV viremia. image