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Kidney Transplantation in Patients with Chronic Hepatitis B Virus Infection
Authors:Teh-Ia Huo  Wu-Chang Yang  Jaw-Ching Wu  Kuang-Liang King  Che-Chuan Loong  Ching-Yuang Lin  Full-Young Chang  Shou-Dong Lee
Affiliation:Department of Medicine, Taipei Veterans General Hospital, Taiwan.
Abstract:
The impact of hepatitis B virus (HBV) infection on the long-term outcome of kidney transplant patients is controversial. A total of 34 chronic hepatitis B surface antigen (HBsAg) carriers among 143 renal allograft recipients were identified in this study (mean follow-up period: 5.6 ± 3.3 years; range: 1–13 years). During the follow-up, one HBsAg-positive recipient with preexisting cirrhosis died of liver failure, and seven (21%) others developed serious HBV-related complications (four fulminant hepatitis, two hepatocellular carcinoma, one cirrhosis), and four died. Although HBsAg-positive recipients had a higher rate of liver-related complications and deaths than HBsAg-negative recipients did, there were no significant differences in the long-term graft and patient survival between the two groups. The survival rates, liver-related complications, and deaths in HBsAg-positive allograft recipients and 28 HBsAg-positive uremic patients under dialysis were similar. In conclusion, HBV infection is not a contraindication to kidney transplantation. However, pretransplant candidates should be warned of potentially serious liver-related complications.
Keywords:chronic hepatitis  hepatitis B virus  hepatocellular carcinoma  immunosuppression  kidney transplantation
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