Introduction: The utilisation of donated kidneys from Hepatitis C (HCV) Ab positive/RNA-positive donors to HCV naïve recipients has been scrutinised in recent years. In Australia, a conservative approach in the acceptance of HCV positive kidneys due to transmission risk has increased the wait time and overall expenditure on patient treatment.
With the development of direct-acting antivirals (DAAs), the use of HCV positive kidneys is becoming more common.
The International Society of Nephrology recommends that kidneys from HCV-infected donors be considered regardless of the HCV status of potential recipients; along with confirmation of availability of DAAs within their institution.
A consenting process that involves informed discussion surrounding the risks versus benefits of acceptance of a HCV positive kidney, requires accurate and timely education prior to being listed for transplant
Objective: To evaluate and identify the current uptake of potential HCV positive kidneys and identify the current practices at a national level.
Method: Retrospective exploratory data analysis of kidney offering and acceptance from NSW donors
Results: Data is sourced from the Australian Organ and Tissue Authority (OTA) Electronic Donor Record (EDR) from 2014 to 2023. A total of 28 consented donors with an RNA NAT positive result were reviewed. 13 proceeded to actual donation and 15 were intended donors. From 2019, kidney donation to HCV naïve recipients was considered with the first successful kidney transplant taking place in 2021
Conclusion: Organ utilisation from HCV positive donors continues to be an evolving practice that requires further discussion, education and awareness from a donation and transplantation perspective.