HCV-infected Renal Transplant Recipients: Our Experience before the Availability of New Antiviral Drugs

Background: Natural history of HCV-infected renal transplant recipients is about to change with the invention of new drugs available for the treatment of HCV. Objective: To analyze the evolution of renal transplant recipients infected with HCV in 30 years of activity of a Renal Transplantation Unit. Methods: We studied 1334 patients who underwent renal transplantation between 1985 and 2015. Results: 189 (14.2%) of these 1334 were found HCV seropositive. 60 were HCV RNA-positive for >6 months. 5 died with a functioning graft; 19 lost their graft and resumed dialysis. Most of the rejections occurred within the first year of the transplantation and none resulted in immediate loss of the graft. In post-transplantation period, 14 patients developed clinical hepatic disease, 10 manifested new-onset diabetes after transplantation, and 4 had de novo neoplasia, none of them had hepatocellular carcinoma. The outcomes of the different variables analyzed were similar between patients with HCV-infection and those with HCV and HBV co-infection. The median survival time was 13.4 (95% CI: 10.7–16.1) years; the median survival time of patients without HCV infection was 14.6 (95% CI: 13.8–15.4) years (p=0.23). Conclusion: In the era before the availability of new anti-HCV drugs, our experience with HCV-infected renal transplant recipients revealed similar post-transplantation complications, graft and patient survival as those not infected with HCV.