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      Long-Term Impact of Hepatitis B, C Virus Infection on Renal Transplantation


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          Chronic liver disease and its complications are major problems in renal transplant recipients. Our aim was to elucidate the influence of hepatitis B, C virus infection on the long-term outcome of renal transplantation. Four hundred and seventy-seven patients who received renal transplantation between January 1984 and December 1999, and who were followed up at our hospital were enrolled. HBsAg was detected by the RIA method and anti-HCV Ab was assayed by the second-generation RIA kit. SGOT/ SGPT were checked every 3 months. Hepatoma was diagnosed by dynamic CT scan, elevated α-fetoprotein, hypervascularity by angiography and confirmed by pathological examination. The prevalence of HBV, HCV, coinfected HBV/HCV was 9.9% (n = 47), 28.5% ( n = 136), 3.1% (n = 15), respectively. The incidences of hepatoma in the HBV–/HCV–, HBV–/HCV+, HBV+/HCV–, HBV+/HCV+ groups were 1.4% (n = 4), 4.4% (n = 6), 6.4% (n = 3), 6.7% (n = 1), respectively (p = 0.114). The incidences of liver cirrhosis/hepatic failure were 3.2% (n = 9) , 6.6% (n = 9) , 21.3% (n = 10) , 20% (n = 3), respectively (p < 0.001). The frequencies of chronic liver disease were 10.4% (n = 29) , 45.6% (n = 62) , 66% (n = 31) , 80% (n = 12), respectively (p < 0.001). Patient and graft survival rates were lower in the HBV-infected group than in the other groups. Cox regression analysis revealed that HBV infection is likely an independent risk factor for patient mortality although the statistical significance was only borderline. Patients with HBV as well as HCV infection were not at risk of graft loss according to this model of analysis. Patients with HBV infection showed higher incidences of hepatoma, hepatic failure, graft failure and death. Therefore, HBV-infected patients who are candidates for renal transplantation should be carefully evaluated. It seems that HCV infection has little influence on the outcome of renal transplant recipients. A longer period of follow-up is needed to clarify the impact of HCV on renal transplant recipients.

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          Most cited references2

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          Early detection of hepatocellular carcinoma in hepatitis-B-positive renal transplant recipients.

          Hepatocellular carcinoma (HCC) is a leading cause of malignancy after renal transplantation in Asia, where hepatitis B virus infection is endemic. Early detection and resection are the key to successful treatment because the mortality rate for HCC is high. The value of alpha-fetoprotein monitoring in the early detection of HCC in renal transplant recipients has not been reported before. We describe 2 patients who had successful resection of HCC following early diagnosis by alpha-fetoprotein monitoring. The epidemiology of post-transplant HCC in various parts of the world and its pathogenesis are discussed.
            • Record: found
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            Hepatitis B surface antigenemia in renal transplant recipients. Increased mortality risk

            W. Hillis (1979)

              Author and article information

              Am J Nephrol
              American Journal of Nephrology
              S. Karger AG
              August 2001
              13 August 2001
              : 21
              : 4
              : 300-306
              aDivision of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital and bChung-Shan Medical and Dental College, Taichung, Taiwan, ROC
              46265 Am J Nephrol 2001;21:300–306
              © 2001 S. Karger AG, Basel

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              Page count
              Figures: 5, Tables: 4, References: 32, Pages: 7
              Self URI (application/pdf): https://www.karger.com/Article/Pdf/46265
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              Self URI (journal page): https://www.karger.com/SubjectArea/Nephrology
              Clinical Study

              Cardiovascular Medicine,Nephrology
              Renal transplantation,Hepatitis B virus,Hepatitis C virus
              Cardiovascular Medicine, Nephrology
              Renal transplantation, Hepatitis B virus, Hepatitis C virus


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