OUTCOME OF RENAL-TRANSPLANTATION IN HEPATITIS BSAG-POSITIVE PATIENTS

Renal transplantation of patients with previous or ongoing hepatitis B virus infection has been tempered with a concern that immunosuppressi on may lead to viral replication and progressive liver damage. However , renal transplantation as therapy for endstage renal failure in these patients improves quality of life and reduces the risk of body fluid exposure to their carers. To assess the long-term outcome of renal tra nsplantation in hepatitis-BsAg-positive patients a retrospective study was carried out on the patients transplanted in this unit since 1969. Seventy-six patients received 98 grafts up to December 1991; follow-u p was available on 68. Thirty-one of the 68 patients died; the causes of death were infective 23, cardiovascular 6, liver failure 4, pancrea titis 2, aspiration 1, GI haemorrhage 1, and stopped therapy 1. Serolo gical markers of hepatitis B virus infection did not correlate with ou tcome. The risk of developing liver failure after renal transplantatio n appears small in the hepatitis-BsAg-positive patients and no patient should be denied a renal transplant on the basis of serological tests .