HCV LIVER-DISEASE IN RENAL-TRANSPLANTATION - A CLINICAL AND HISTOLOGICAL STUDY

The prevalence of HCV infection is high in renal transplantation (RT) patients: 29% in our cohort of 399 RT recipients. The consequences of that infection on the liver have to be carefully assessed. Clinical ch ronic hepatitis was detected from ALT concentrations (> x 1.5 N) in on ly 26 patients (22%) with constant (15%) or fluctuating (85%) ALT elev ation. Only three of 117 cases developed cirrhosis (3%). No liver canc er was noted. Liver biopsy was performed (mean interval = 60.2 months) in 62 patients with HCV infection alone. We found 26 cases (42%) of c hronic active hepatitis (CAH) with a mean Knodell score as low as 6.1 (range: 3-12), a mean activity grade of 4.9, and a fibrosis stage of 1 .3. Twelve patients (19%) presented with normal liver pathology and me t the criteria of healthy HCV carriers (positive viraemia, normal ALT and normal liver). The rest presented with portal lesions, either infl ammation or fibrosis. In addition. patient and graft survival rates di d not differ in HCV + recipients. To conclude, HCV infection did not a ppear too deleterious for the liver in this cohort of patients. There is therefore no contraindication for HCV-positive recipients to underg o renal transplantation.