Characterization and utilization of HCV-positive donors in Argentina
Manuel Mendizabal1, Margarita Anders Dr2, Ariel Antik Dr..4, Federico Piñero Dr.1, Gabriela Hidalgo Dr.3, Daniela Hansen Krogh Mrs4, Viviana Tagliafichi Mrs4, Florencia Antinucci Dr.2, Federico Orozco Ganem Dr.2, Marcelo O Silva Prof.1, Liliana Bisigniano Dr.4.
1Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina; 2Hepatology and Liver Transplant Unit, Hospital Aleman, Buenos Aires, Argentina; 3Dirección Médica, Instituto Único Coordinador de Ablación e Implante (INCUCAI), Buenos Aires, Argentina; 4Dirección Científico Técnico, Instituto Único Coordinador de Ablación e Implante (INCUCAI), Buenos Aires, Argentina
Background & Aims: Increased utilization of hepatitis C virus (HCV)-positive organ donors has been endorsed as one of several ways to combat organ shortages. However, HCV-positive donors remain poorly characterized and utilization of HCV-positive donors is unclear. Thus, we aimed to evaluate the prevalence and utilization of HCV antibody (Ab) positive donors in Argentina.
Methods: We performed a cross-sectional study to analyze data from the National Coordinating Institute of Ablation and Implant (INCUCAI) in Argentina from January 2006 to December 2020. Demographic and allograft characteristics were evaluated, and utilization of HCV Ab-positive donors across Argentina was studied. We included data from all donors, including effective organ donors (those for whom transplantation was effectively done), non-effective organ donors, and tissue only donors that were discarded. Anti-HCV (ELISA), was performed on all donors during the procurement process. A stratified analysis according to the type of donor and HCV Ab was done.
Results: Overall, 16,140 deceased donors were denounced. Of these, 8627 (53.5%) were organ donors (7802 [90.4%] were effective) and 7513 (46.5%) were tissue donors. Demographic characteristics were age 42 ± 18 years and male/female ratio was 1.59/1. HCV Ab-positive was reported in 0,92% (n=149). The highest prevalence of HCV was found in the provinces of Río Negro and Jujuy (1,9%), followed by Cordoba (1,5%) and the City of Buenos Aires (1,3.%). Prevalence ratio per period among HCV Ab-positive donors showed that the highest prevalence was observed in 2007 (1.3%) and the lowest prevalence was in 2020 (0.1%). Prevalence for HCV Ab-positive among type of donors was significantly higher in non-effective donors 5.81% (n=48/825), followed by tissue donors only 1.01% (n=76/7513 and lower in effective donors 0.32% (n=25/7802; P<0.0001). Organ donors with HCV Ab-positive serology had less acceptance rate than those with HCV Ab-negative (34% vs 90%; respectively, p<0.001). The solid organ transplants performed using HCV Ab-positive donors were 23 kidney, 5 liver and 1 heart transplant; of these, only 4 transplants were performed after the advent of the new direct-acting antivirals in 2016. Five-year recipient and graft survival in kidney and liver recipients was not adversely impacted by donor HCV Ab-positive status.
Conclusion: The prevalence of HCV Ab-positive donors in Argentina is low and declining. Therefore, expanding the donor pool using HCV Ab-positive donors is a limited strategy in our country.
