H. Mansy et al., HEMODIALYSIS-PATIENTS WITH HEPATITIS-C - SHOULD THEY BE CONSIDERED FOR RENAL-TRANSPLANT, Saudi medical journal, 16(6), 1995, pp. 522-526
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.