Impact of hepatitis C virus status in pancreas transplantation: a case controlled study

Available data suggest that hepatitis C virus positive (HCV+) renal transplant patients may be at an increased risk of morbidity and mortality compared with HCV− patients. Limited data are available regarding the impact of HCV status in pancreas transplant patients. We compared the outcomes of 10 HCV+ patients undergoing pancreas transplantation (seven simultaneous kidney‐pancreas, one pancreas after kidney, two pancreas alone) between 1/96 and 10/99 with 20 HCV− recipients that were matched for age, race, gender, timing of transplant, type of pancreas transplant, and surgical technique. Length of follow‐up was not significantly different between the HCV+ group compared with the HCV− group (24 ± 14 vs. 20 ± 13 months; p=0.45). There was a trend toward a higher incidence of all cause mortality in HCV+ recipients compared with HCV− recipients, 30 vs. 10%, respectively (p=0.17). Additionally, the HCV+ recipients had a trend toward a higher incidence of sepsis‐related mortality compared with HCV− recipients, 20 vs. 5%, respectively (p=0.19). Renal allograft survival was 50% in the HCV+ group compared with 94% in the HCV− group (p=0.02). Pancreas allograft survival was not significantly different between the groups, 60 vs. 80%, respectively (p=0.24). At 3, 6, 12 months, and end of follow‐up, there were no differences in serum creatinine, amylase, C‐peptide, or fasting glucose levels. However, there was a significantly higher incidence of proteinuria at last follow‐up in the HCV+ recipients with a renal allograft when compared with HCV− recipients, 50 vs. 12.5%, respectively (p=0.05). In order to maintain comparable glycemic control between the groups, there was a significant increase in oral hypoglycemic requirement in HCV+ recipients compared with HCV− recipients, 33 vs. 0%, respectively (p=0.01). These data suggest that HCV+ pancreas transplant patients may be at an increased risk of graft dysfunction and morbidity. Further studies with more patients and longer follow‐up are needed to fully define the impact of HCV status on pancreas graft survival and function.