{"doi":"10.1053/j.ajkd.2022.12.019","title":"Kidney Transplantation From Hepatitis C Virus–Infected Donors to Uninfected Recipients: A Systematic Review for the KDIGO 2022 Hepatitis C Clinical Practice Guideline Update","abstract":null,"journal":"American Journal of Kidney Diseases","year":2023,"id":628985,"datarank":0.4566783656585135,"base_score":3.044522437723423,"endowment":3.044522437723423,"self_citation_contribution":0.4566783656585135,"citation_network_contribution":0.0,"self_endowment_contribution":0.4566783656585135,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":20,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":795391,"name":"Gaelen P. Adam","orcid":"0000-0002-1103-9205","position":1,"is_corresponding":false},{"id":109011,"name":"Michel Jadoul","orcid":"0000-0001-7369-7812","position":2,"is_corresponding":false},{"id":1373082,"name":"Paul Martin","orcid":"0009-0002-2598-4520","position":3,"is_corresponding":false},{"id":14753,"name":"Ethan M. Balk","orcid":"0000-0002-4376-7290","position":4,"is_corresponding":false},{"id":322669,"name":"Craig E. Gordon","orcid":"0000-0001-6895-5127","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Kidney Transplantation From Hepatitis C Virus–Infected Donors to Uninfected Recipients: A Systematic Review for the KDIGO 2022 Hepatitis C Clinical Practice Guideline Update","abstract":"<h4>Rationale & objective</h4>Direct-acting antiviral (DAA) treatment of hepatitis C virus (HCV) infection in patients with chronic kidney disease (CKD) has made transplantation of kidneys from HCV-infected donors to uninfected recipients (D+/R-) feasible. To facilitate an update to the 2018 KDIGO guideline for patients with CKD and HCV, we conducted a systematic review of HCV D+/R-kidney transplantation coupled with DAA treatment.<h4>Study design</h4>Systematic review and meta-analysis.<h4>Setting & study populations</h4>We included studies of HCV D+/R-kidney transplantations that used any DAA protocol.<h4>Selection criteria for studies</h4>Based on a search of PubMed, Embase, Cochrane, CINAHL, and ClinicalTrials.gov through February 1, 2022, conferences from 2019 to 2021, and the 2018 KDIGO HCV guideline we identified single-group (D+/R-) or comparative studies of D+/R-versus D-/R-kidney transplantation.<h4>Data extraction</h4>Conducted in SRDR-Plus with review by a second researcher.<h4>Analytical approach</h4>Maximum likelihood meta-analyses; the certainty of evidence was assessed per GRADE (Grading of Recommendations Assessment, Development and Evaluation).<h4>Results</h4>We identified 16 studies (N=557). A sustained viral response at 12 weeks after treatment (SVR12) was observed in 97.7% (95% CI, 96.3%-98.8%). Ultrashort duration treatment (≤8 days) resulted in viremia requiring standard-course DAA treatment in some patients, all of whom achieved SVR12 after 1 or rarely 2 DAA courses. Serious adverse events from DAA treatment were rare after D+/R-transplantation (0.4% [95% CI, 0.1%-2.8%]). At≥1 year after D+/R-transplantation, recipient death occurred in 2.1% (95% CI, 0.9-3.7) and allograft survival was 97.6% (95% CI, 95.7%-98.9%). Estimated glomerular filtration rate 1 year after transplantation ranged from 46 to 74mL/min/1.73m<sup>2</sup>.<h4>Limitations</h4>Analyses were generally based on low-certainty evidence. Uncertainty exists about the long-term safety and efficacy of D+/R-transplantation. Few studies investigated ultrashort treatment courses.<h4>Conclusions</h4>Kidney transplantation from HCV-infected donors to uninfected recipients followed by DAA treatment appears to be safe and associated with excellent 1-year clinical outcomes.<h4>Plain-language summary</h4>Due to the high efficacy of direct-acting antivirals (DAA), the use of kidneys from HCV-infected deceased donors may increase rates of kidney transplantation. We conducted a systematic review for the 2022 KDIGO Clinical Practice Guideline on Hepatitis C to evaluate the safety and efficacy of kidney transplantation from HCV-infected donors to uninfected recipients (D+/R-) followed by DAA therapy. Sixteen studies comprising 557 patients revealed high rates of sustained viral response, low rates of adverse events, and excellent patient and allograft survival 1 year after transplantation. Kidney transplantation from HCV-infected deceased donors to uninfected recipients treated with DAA appears safe and effective. Future studies should investigate shorter treatment durations, monitor safety, and obtain longer-term efficacy data.","is_dataset_classified":null,"base_score":3.044522437723423,"endowment":3.044522437723423,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"37061019","pmcid":null,"openalex_id":"https://openalex.org/W4365518324","authors":[],"funders":[],"total_grants":0,"fwci":1.8677,"citation_percentile":0.85098039,"influential_citations":0,"citation_trend":[{"year":2023,"count":2},{"year":2024,"count":5},{"year":2025,"count":7},{"year":2026,"count":6}],"oa_status":"bronze","license":"http://creativecommons.org/licenses/by-nc-nd/4.0/","oa_locations":[{"url":"http://www.ajkd.org/article/S0272638623005929/pdf","host_type":"journal"},{"url":"http://www.ajkd.org/article/S0272638623005929/pdf","host_type":"publisher"},{"url":"https://api.elsevier.com/content/article/PII:S0272638623005929?httpAccept=text/xml","host_type":"publisher"},{"url":"https://api.elsevier.com/content/article/PII:S0272638623005929?httpAccept=text/plain","host_type":"publisher"},{"url":"https://doi.org/10.1053/j.ajkd.2022.12.019","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/37061019","host_type":"repository"},{"url":"http://hdl.handle.net/2078.1/272294","host_type":"repository"}],"fields_of_study":["Hepatitis C virus research","Renal Transplantation Outcomes and Treatments","Hepatitis B Virus Studies","Humans","Antiviral Agents","Hepacivirus","Kidney Transplantation","Hepatitis C, Chronic","Hepatitis C","Renal Insufficiency, Chronic","Tissue Donors"],"mesh_terms":["Antiviral Agents","Hepatitis C","Humans","Tissue Donors","Kidney Transplantation","Hepacivirus","Hepatitis C, Chronic","Renal Insufficiency, Chronic"],"keywords":["Medicine","Guideline","Kidney transplantation","Virology","Transplantation","Hepatitis C virus","Clinical Practice","Hepatitis B virus","Immunology","Intensive care medicine","Internal medicine","Virus","Pathology","Family medicine","Meta-analysis","hepatitis C","Chronic Kidney Disease","Direct-acting Antivirals","Kidney Transplantation Systematic Review"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-05T15:51:32.419687Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}