Risk of Post-transplantation Hepatocellular Carcinoma, Cirrhosis, and Liver Failure in Kidney Recipients with Hepatitis C Infection

Background: Hepatitis C virus (HCV) infection is prevelant in patients with end stage renal disease (ESRD). Compared to ESRD with dialysis, kidney transplantation offers a survival advantage for ESRD patients. To the present, ESRD with HCV infection remains an acceptable candidate for kidney transplantation. However, HCV is the leading cause resulting in hepatic complications after transplantation. Data to elucidate the liver issue in renal transplant patients with HCV infection are scarce . In the present study, we aimed to investigate the hepatic outcomes of renal transplantation with HCV infection. Methods: Data Source TriNetX is a multicenter federated health research network. Our study population is drawn from 89 Healthcare Organization (HCOs). Patients received kidney transplantation [ICD-10: Z94.0] and those with HCV were case group in this study, while those without HCV were control group. Propensity score matching (PSM) with ratio 1:1 was applied including sex, age at index, and comorbidities. Results: A total of 6,605 renal recipients with HCV infection and 188.466 renal recipients without HCV infection were enrolled.After PSM, 6,473 were in each group, respectively. In the study population, over 60% of the patients were male and aged between 40-65. After matching, our findings showed that subjects with HCV infecton had significantly higher risk of hepatoma, cirrhosis, hepatic failure, and overall hepatic disease than those without HCV infection. ( hepatoma: HR: 8.957; CI: 5.324-15.069; cirrhosis: HR: 5.378; CI: 4.363-6.631; hepatic failure: HR: 3.258; CI: 2.527-4.200;; overall hepatic disease: HR: 4.128; CI: 3.428-4.971) Conclusion: In the present study, our findings show that renal recipients with HCV infection is significantly associated with a remarkably high risk of hepatic complications including hepatoma, cirrosis and liver failure post-kidney transplanttaion and that has been ignored previously. Professionals should pay more attention while taking care of renal recipients with HCV infection. The eradication of HCV therapy by Direct-acting antivirals (DAAs) should be considered.