CHRONIC HEPATITIS IN RENAL TRANSPLANTED P ATIENTS - THE IMPORTANCE OFHEPATITIS

In order to determine the role of hepatitis C virus in the causation o f chronic liver disease (CLD), we studied 198 renal-transplant recipie nts. 23% of the recipients were diagnosed has having CLD. Of 43 (69%) patients, 49% were anti-HCV positive, 13% HBsAg positive and 7% were p ositive for both anti-HCV and HBsAg. Among the remaining cases, there was evidence of contact with HCV or HBsAg virus prior to transplantati on in more than half the patients. The frequency of CLD was significan tly high among patients who had seroconverted to hepatitis C virus (90 % out of every 10 cases) and among those were seropositive before the time of transplantation and remained anti-HCV positive (40%). Besides the presence of current viral markers and anti-HCV seroconversion, the multivariable study showed three major risk factors for the acquisiti on or posttransplant CID: male sex, number of transfusions of blood du ring dialisis (HCV with positive markers), or peritransplant blood tra nsfusions (HCV without markers). A review of the clinical and histolog ical evolution of the patients who seroconverted to HCV showed a commo n evolution towards severe hepatopaty. Patients with negative markers may also present this kind of clinical course. Hepatitis C is the most common cause of CLD among the renal transplant recipients of our seri es. The role that HCV plays in the pathogenesis of CID may be better u nderstood by the use of more sensitive viral markers. Acquisition of t he disease during the peritransplant period may be specially serious.