Objectives: Our objective was to study the outcomes of hepatitis C-positive renal transplant recipients compared with hepatitis C-negative renal transplant recipients. All-cause unadjusted, death-censored graft survival and patient survival were all significantly lower in hepatitis C-positive recipients (P < .0001). One-year acute rejection rates were higher in the hepatitis C-positive group (17.2% vs 14.6%; P = .001). Within the hepatitis C-positive group, graft survival was inferior for those who received a hepatitis C-positive donor kidney compared with a hepatitis C-negative donor kidney and those who received a deceased-donor kidney as compared with a living-donor kidney. In multivariate and Cox regression analyses, the adjusted hazard ratio for graft failure for hepatitis C positive was 1.34 (P < .001, 95% confidence interval, 1.31-1.37). Conclusions: Even in today's era, this updated analysis still shows major inferior outcomes in hepatitis C-positive transplant recipients. Hence, aggressive treatment for hepatitis C before and after should be considered. Materials and Methods