Temporal Changes in the Utilization of Kidneys from Hepatitis C Virus-Infected Donors in the United States.

Despite data demonstrating increased utilization of kidneys from hepatitis C virus (HCV)-infected donors, it is unknown whether: 1) this is due to an increase in the donor pool or improved organ utilization, and 2) data from early pilot trials was temporally associated with changes in organ utilization. We used data from the Organ Procurement and Transplantation Network of all kidney donors and recipients of kidney transplants from 1/1/2015-3/31/2022 to evaluate temporal changes using Joinpoint regression. Our primary analyses compared donors based on their HCV viremic status (HCV-infected vs. HCV-negative). Kidney utilization changes were assessed by evaluating kidney discard rate and kidneys transplanted per donor. A total of 81,833 kidney donors were included in the analysis. There was a statistically significant decrease in discard rates of HCV-infected kidney donors from 40% to just over 20% over a 1-year period, with a concurrent increase in kidneys transplanted per donor. This increased utilization occurred in tandem with the publication of pilot trials involving HCV-infected kidney donors in HCV-negative recipients rather than an increase in the donor pool. Ongoing clinical trials may strengthen existing data which could result in this practice becoming the accepted standard of care.