Kidney transplantation in patients with chronic hepatitis B virus infection - Is the prognosis worse?

The impact of hepatitis B virus (HBV) infection on the long-term outcome of kidney transplant patients is controversial. A total of 34 chronic hepatit is B surface antigen (HBsAg) carriers among 143 renal allograft recipients were identified in this study (mean follow-up period: 5.6 +/- 3.3 years; ra nge: 1-13 years). During the follow-up, one HBsAg-positive recipient with p reexisting cirrhosis died of liver failure, and seven (21%) others develope d serious HBV-related complications (four fulminant hepatitis, two hepatoce llular carcinoma, one cirrhosis), and four died. Although HBsAg-positive re cipients had a higher rate of liver-related complications and deaths than H BsAg-negative recipients did, there were no significant differences in the long-term graft and patient survival between the two groups. The survival r ates, liver-related complications, and deaths in HBsAg-positive allograft r ecipients and 28 HBsAg-positive uremic patients under dialysis were similar . In conclusion, HBV infection is not a contraindication to kidney transpla ntation. However, pretransplant candidates should be warned of potentially serious liver-related complications.