Transplant of a Kidney from a Hepatitis C Viremic Donor to a Naïve Recipient without Viral Transmission: A Case Report

Patient: Male, 49-year-old Final Diagnosis: HCV infection Symptoms: Haematuria Medication:— Clinical Procedure: — Specialty: Transplantology OBJECTIVE: Unusual clinical course BACKGROUND: Kidneys from deceased donors who were positive for hepatitis C virus (HCV) on a nucleic acid amplification test (NAT) are not given to anti-HCV antibody-negative recipients. This is because of the high risk of HCV transmission, combined with the lack of effective antiviral treatment. Several studies have demonstrated rates of transmission of HCV from anti-HCV-positive/HCV NAT-positive donors to anti-HCV-negative recipients of 100%. Ours is the first report of transplantation of a kidney from an anti-HCV antibody-positive/HCV NAT-positive donor into an anti-HCV antibody-negative recipient who remains anti-HCV antibody-negative at 3 months after transplant with no treatment. CASE REPORT: A 49-year-old man had a history of end-stage renal disease that was presumed to be secondary to type ll diabetes. He received a kidney from a deceased donor who was HCV antibody-positive/NAT-negative. The patient’s HCV antibody status was checked prior to transplant and he was found to be negative and non-reactive. Since the transplant, his HCV viral load has been checked 5 times, on postoperative days 15, 23, 44, 62, and 64; each time, it has been undetectable. Furthermore, the patient’s HCV antibody status was rechecked 1 month after transplant and it remained negative and nonreactive. CONCLUSIONS: Further research is required on the accuracy of polymerase chain reaction as an indicator of donor HCV infection when the quantity of the viral load is not reported.