RENAL-TRANSPLANTATION IN ASYMPTOMATIC CARRIERS OF HEPATITIS-B SURFACE-ANTIGEN

The aim of the present study was: (a) to assess the effect of HBsAg on the survival of both renal grafts and patients, and (b) to determine the outcome of HBV chronic infection after renal transplantation. Four teen patients seropositive for HBsAg but asymptomatic before renal tra nsplantation (group A) were included in the study. The results were co mpared to those of 14 transplanted patients (group B) seronegative for HBsAg with similar age and immunosuppressive treatment. Four patients received a graft from a living-related donor and 10 patients from a c adaver donor in each group. Eight of 14 patients of group A showed, af ter renal transplantation, chronic hepatitis, which was not observed i n any of the group B patients (p<0.01). The rate of acute rejection ep isodes was significantly greater (p<0.05) in group B than in group A. The graft survival was found to be similar in both groups at the Ist y ear, but significantly less (p<0.01) in group B than in group A at the 5th year after transplantation. The survival of patients was found to be significantly less in group A than in group B at the Ist (p<0.05) and 5th years (p<0.01) after transplantation. In 2 patients of group A and 1 of group B anti-HCV was found, while HDAg plus anti-HD was foun d in 1 patient of group B. The HBV-DNA was found in 4 of 8 alive patie nts of group A. It is suggested that HBsAg after renal transplantation is associated with the reduction of patient survival, despite the red uction of acute rejection episodes and better renal graft survival.