Long-term impact of hepatitis B, C virus infection on renal transplantation

Chronic liver disease and its complications are major problems in renal tra nsplant recipients. Our aim was to elucidate the influence of hepatitis B, C virus infection on the long-term outcome of renal transplantation. Four h undred and seventy-seven patients who received renal transplantation betwee n January 1984 and December 1999, and who were followed up at our hospital were enrolled. HBsAg was detected by the RIA method and anti-HCV Ab was ass ayed by the second-generation RIA kit. SGOT/SGPT were checked every 3 month s. Hepatoma was diagnosed by dynamic CT scan, elevated a-fetoprotein, hyper vascularity by angiography and confirmed by pathological examination. The p revalence of HBV, HCV, coinfected HBV/HCV was 9.9% (n = 47), 28.5% ( n = 13 6), 3.1 % (n = 15), respectively. The incidences of hepatoma in the HBV-/HC V-, HBV-/HCV+, HBV+/HCV-, HBV+/ HCV+ groups were 1.4% (n = 4), 4.4% (n = 6) , 6.4% (n = 3), 6.7% (n = 1), respectively (p = 0.114). The incidences Of l iver cirrhosis/hepatic failure were 3.2% (n = 9), 6.6% (n = 9), 21.3% (n = 10), 20% (n = 3), respectively (p < 0.001). The frequencies of chronic live r disease were 10.4% (n = 29), 45.6% (n = 62), 66% (n = 31), 80% (n = 12), respectively (p < 0.001). Patient and graft survival rates were lower in th e HBV-infected group than in the other groups. Cox regression analysis reve aled that HBV infection is likely an independent risk factor for patient mo rtality although the statistical significance was only borderline. Patients with HBV as well as HCV infection were not at risk of graft loss according to this model of analysis. Patients with HBV infection showed higher incid ences of hepatoma, hepatic failure, graft failure and death. Therefore, HBV -infected patients who are candidates for renal transplantation should be c arefully evaluated. It seems that HCV infection has little influence on the Outcome of renal transplant recipients. A longer period of follow-up is ne eded to clarify the impact of HCV on renal transplant recipients. Copyright (C) 2001 S. Karger AG, Basel.