The HCV-Positive Donor Kidney

This flow follows the controversy over using kidneys from HCV-positive donors for HCV-positive recipients.

increasingBearing stren­gth in each eventdecreasing

Transmission Recognized

Transmission Recognized Organ as vehicle Kidney transplantation from an HCV-positive donor can transmit infection, with risk varying according to donor viremia, viral burden, preservation, and testing. Seropositivity alone does not establish immunity. Ethical consequence Discarding every such kidney protects some recipients but wastes organs during a severe shortage. The problem becomes one of controlled risk rather than absolute safety.

Recipient Restriction

Recipient Restriction Narrowing eligibility Experience led centers to restrict HCV-positive donor kidneys to recipients with active HCV RNA and informed consent. This approach avoids creating new infections in previously uninfected recipients. Imperfect protection Existing antibodies do not prevent reinfection or superinfection. Nevertheless, restriction sharply improves the ethical balance between organ use and preventable transmission.

Organ Shortage Reframed

Organ Shortage Reframed Long-term reassurance Long follow-up suggests that donor HCV serology is not independently responsible for poor survival when the recipient is already infected. Waiting time may be substantially shorter. A practical resolution The remaining challenge is organization: identifying suitable recipients, confirming viral status, obtaining consent, and avoiding unnecessary discard. The donor kidney becomes a usable resource rather than a forbidden object.

early 1990s

after policy revision in the 1990s

around 2010