Longer-Term Clinical Outcomes of Transplantation of HCV-RNA+ Donor Kidneys Into Hepatitis C Virus-Negative Recipients

2) Our returning guest author is @happiedoc
Our topic for 🆓 CE/#CME: Longer-Term Clinical Outcomes From the #THINKER and #EXPANDER Trials of Transplantation of #HCV-RNAD Donor Kidneys Into Hepatitis C Virus-Negative Recipients#MedTwitter #nephtwitter @ISNkidneycare pic.twitter.com/6TGrbQ2suu

— @CKD_ce (@ckd_ce) January 3, 2024

4) FOLLOW US at @ckd_ce and at @KIReports for more expert #MedEd in #kidneydisease. #FOAMed @MedTweetorials

— @CKD_ce (@ckd_ce) January 3, 2024

6) New hope that organs from HCV-RNA+ donors could be safely transplanted arose from the introduction of a direct-acting antiviral (#DAA) therapy and high #HCV cure rates following treatment.

— @CKD_ce (@ckd_ce) January 3, 2024

8) ✅Both trials reported 100% #HCV cure rates and good #allograft function through 12 months.
👍 Encouraging early results, as well as the growing number of HCV-RNA+ organ donors, motivated wider use of HCV-RNA+ donor organs by #transplant centers. pic.twitter.com/s3SyaOpBnG

— @CKD_ce (@ckd_ce) January 3, 2024

10a) 🧾 In this #tweetorial, we discuss about #longterm clinical outcomes from #THINKER & #EXPANDER trials; data collected from usual care until 3y post transplant has now been published in @KIReports:🔓 https://t.co/jAiJnRzTAt

— @CKD_ce (@ckd_ce) January 3, 2024

11) Reported:
📌Allograft survival & function
📌Immunologic complications: rejection & development of de novo donor specific antibodies (#DSA)
📌#eGFR trajectories v matched comparators
📌Estimated future allograft survival using the integrative Box #iBox scoring system

— @CKD_ce (@ckd_ce) January 3, 2024

13) 📌 #Diabetes or #hypertension: primary cause of end-stage kidney disease #ESKD in 51% of recipients.
📌 Median days to transplantation from wait-listing: 360 (IQR 184–521)
📌 All participants received rabbit antithymocyte globulin (#ATG) for induction

— @CKD_ce (@ckd_ce) January 3, 2024

15) 🔪 8 (18%) recipients underwent a kidney biopsy (7 in THINKER & 1 in EXPANDER)
📌 Check the details below: pic.twitter.com/HxtX7uwwtS

— @CKD_ce (@ckd_ce) January 3, 2024

16b) 📌6 patients developed de novo #DSA
📌 Median highest DSA:
class 1 DSA: 2204 mean fluorescent index #MFI
class 2 DSA: 2777 MFI

— @CKD_ce (@ckd_ce) January 3, 2024

18) ⏳Predictions of future allograft survival using the iBox scoring system showed similar median allograft survival up to 10 years post-transplant
📌Median allograft survival, post-transplant:
⚡At 6 years: 97.6%
⚡At 8 years: 96.1%
⚡At 10 years: 94.3% pic.twitter.com/WnAAo4PZNL

— @CKD_ce (@ckd_ce) January 3, 2024

20) Why should one include HCV-RNA+ donor kidneys?
⚡ HCV+ donors who die from #opioid overdose may be young & have a short period of active infection
⚡These allografts may function well despite some #HCV injury
⚡ #DAA rapidly eradicates HCV & may limit injury post-Xplant

— @CKD_ce (@ckd_ce) January 3, 2024

22) Let me leave you with questions to ponder:
📌Does that mean we may see more of transplants involving HCV-RNA+ kidneys in the future?
📌Will these positive results get extrapolated to larger, less optimal population?

— @CKD_ce (@ckd_ce) January 3, 2024

23b) It’s b, development of direct-acting antiviral (#DAA) therapy ➡️ high #HCV cure rates following treatment.
Now: #DSA predicts what?
a. Histological status of allograft at 1y
b. eGFR at 3y
c. risk of antibody-mediated rejection
d. none of the above

— @CKD_ce (@ckd_ce) January 3, 2024

24) You just earned 0.5hr 🆓CE/CME! Claim your certificate now at https://t.co/E4IBIgUgXs and share this #tweetorial with your followers and friends! Thanks to @happiedoc for authoring & @sophia_kidney for managing!#FOAMed #nephtwitter @ISNkidneycare @KIReports @goKDIGO

— @CKD_ce (@ckd_ce) January 3, 2024