People on dialysis and waiting for a kidney transplant would do better to receive a hepatitis C virus (HCV)–infected organ in the short term rather than waiting longer for a kidney without the virus.
Publishing their findings in the Annals of Internal Medicine, researchers conducted an analysis based on computer modeling that drew data from various sources, including the United States Renal Data System, published medical literature and clinical trials. With the goal of predicting medical and cost-related outcomes over an individual’s lifetime, the model took into account several factors, including sex, age, HCV-driven liver damage severity and the cost of treatment.
According to the model, transplanting an HCV-infected kidney into someone on dialysis and then treating him or her for the virus would be more effective and would cost less than treating hep C before transplantation. Much of the benefit was driven by the difference in wait times for an HCV-negative versus an HCV-positive organ—eight months versus two years. Additionally, about 15 percent of U.S. residents on dialysis already have hep C.
By receiving an HCV-positive organ instead of an HCV-negative one, the typical 58-year-old on dialysis would accrue an additional six months of quality adjusted life years, which is a composite measurement of improved overall health and extended life span. The lifetime cost savings would amount to about $41,600.
Post-transplant, the death rate for those who were relying on dialysis drops from about 7.5 percent per year to 2 percent per year.
To read a press release about the study, click here.
To read the study abstract, click here.