HEMODIALYSIS-PATIENTS WITH HEPATITIS-C - SHOULD THEY BE CONSIDERED FOR RENAL-TRANSPLANT

Objectives: To evaluate the relationship between transaminase (ALT/AST ) levels and liver histology in patients with hepatitis C (HCV) antibo dies and draw guidelines for assessing the suitability of haemodialysi s patients with HCV for renal transplant (RT). Subjects: All patients were medically stable, with no recent viral illness and all had a hist ory of previous blood transfusion. All had previously been infected wi th hepatitis A and cytomegalovirus (CMV), and nine had previously been infected with hepatitis B. None were known to be faking hepatotoxic m edication and none had any stigmata of chronic liver disease. Setting: North West Armed Forces Hospital, Tabuk. Results: There was no correl ation between the level of transaminase (ALT and AST) serum albumin, o r the severity of the histopathological finding. Three had chronic act ive hepatitis (CAH) and two had chronic persistent hepatitis; eight ha d chronic lobular hepatitis. Conclusion: It is difficult to predict th e effect of long-term immunosuppressive treatment or the progression o f HCV infection after RT. A patient with CAH or early cirrhosis should be excluded. Transaminase is no guide to the liver histology and live r biopsy is essential to rule out chronic liver disease prior to RT.