Outcome of renal graft recipients with hepatitis C virus infection

  • A. Rodrigues
  • T. Morgado
  • A. Castro Henriques
  • A. Morais Sarmento
  • M. Pereira
  • S. Guimarãcs
Conference paper

Abstract

Hepatitis C virus (HCV) is a major cause of posttransplantation chronic liver disease. The aim of this study was to evaluate the prevalence of HCV in renal transplant recipients and to investigate risk and prognostic factors. Of 427 renal transplants carried out between July 1983 and January 1993, we retrospectively studied 66 (15.5 %) HBsAg-negative patients with anti-HCV detected by enzyme-linked immunosorbent assay (ELISA) and recombinant immunoblot assay (RIBA). Patient and graft survivals were estimated. Anti-HCV positive patients had more time on hemodialysis and pretransplant blood transfusions (P = 0.0001) than did the seronegative population. In a mean follow-up of 52.3 ± 27.7 months, 36 patients (54 %) had biochemical evidence of liver disease, predominantly with a persistently high pattern of serum alanine aminotransferase (ALT). Pretransplantation ALT elevation was associated (P = 0.004) with chronic liver disease (CLD) in the graft recipient. None of the other variables studied predicted posttransplantation CLD. Liver failure occurred in two (3 %) and was the cause of death in one of the patients. Death occurred in eight significantly more aged (P = 0.0001) patients, at 45.5 ± 28.8 months posttransplant. In 50 % of the cases, death was ascribed to sepsis. The biochemical pattern of HCV showed no predictive value for prognosis. The disease had no significant effect on the number of rejections or graft survival. The study revealed lower actuarial survival (P = 0.004) for HCV-positive patients in comparison with the seronegative population.

Key words

Hepatitis C Kidney transplantation 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Dubois DB, Gretch D, et al (1994) Am J Kidney Dis 24: 795–801PubMedGoogle Scholar
  2. 2.
    Morales M, Campo C, Castellano G, Colina F, et al (1992) Transplant Proc 24: 78–80PubMedGoogle Scholar
  3. 3.
    Ponz E, Campistol JM, Barrera JM, et al (1991) Transplant Proc 23: 1371–1372PubMedGoogle Scholar
  4. 4.
    Pereira BJG (1993) Curr Opin Nephrol Hypertens 2: 912–922PubMedCrossRefGoogle Scholar
  5. 5.
    Oliveras A, Lloveras J, Puig JM, et al (1991) Transplant Proc 23: 2636–2637PubMedGoogle Scholar
  6. 6.
    Chan TM, Lok ASF, Cheng IKP (1991) Transplantation 52: 810–813PubMedCrossRefGoogle Scholar
  7. 7.
    Druwe PM, Michielsen PP, Ramon AM, De Broe ME (1994) Nephrol Dial Transplant 9: 230–237PubMedGoogle Scholar
  8. 8.
    Gomez E, Aguado S, Gago E, et al (1991) Transplant Proc 23: 2654–2655PubMedGoogle Scholar
  9. 9.
    Tesi Raymond J, Waller K, Morgan CJ, et al (1994) Transplantation 57: 826–831CrossRefGoogle Scholar
  10. 10.
    Pereira BJG, Milford EL, Kirman RL, et al (1993) Transplant Proc 25: 1458–1459PubMedGoogle Scholar
  11. 11.
    Morales JM, Andres A (1993) N Engl J Med 328: 511PubMedCrossRefGoogle Scholar
  12. 12.
    Miller J, Roth D, Schiff ER (1993) N Engl J Med 328: 512PubMedGoogle Scholar
  13. 13.
    Candinas D, Joller Jemelka HI, Largiader F (1993) N Engl J Med 328: 512PubMedGoogle Scholar
  14. 14.
    Pereira BJG, Levey AS (1993) N Engl Med 328: 513CrossRefGoogle Scholar
  15. 15.
    Vincenti F, Weber P, Kuo G, et al (1991) Transplant Proc 23: 2651–2652PubMedGoogle Scholar
  16. 16.
    Morales JM, Munoz MA, Castellano G, et al (1993) Transplant Proc 25: 1450–1453PubMedGoogle Scholar
  17. 17.
    Rao KV, et al (1993) Am J Med 94: 241–250PubMedCrossRefGoogle Scholar
  18. 18.
    Ihara H, Ikoma F (1994) Transplant Proc March: 781Google Scholar
  19. 19.
    Boyce NW, et al (1988) Am J Kidney Dis 11: 307–312PubMedGoogle Scholar
  20. 20.
    Lobato L, et al (1994) Rev Port Nefrol Hipert 8: 113–121Google Scholar
  21. 21.
    Roth D, et al (1994) Kidney Int 45: 238–244PubMedCrossRefGoogle Scholar
  22. 22.
    Fernandez JA, Roth D, et al (1991) Transplant Proc 23: 444–445PubMedGoogle Scholar
  23. 23.
    Goffin E, Pirson Y, Cornu C, et al (1994) Kidney Int 45: 551–555PubMedCrossRefGoogle Scholar
  24. 24.
    Orloff SL, Stempel CA, Wright TL, et al (1995) Clin Transpl 9: 119–124Google Scholar
  25. 25.
    Pol S (1994) Actualités néphrologiques. Flammarion Medecine-Sciences, ParisGoogle Scholar
  26. 26.
    Caramelo C, et al (1993) Am J Kidney Dis 22: 822–828PubMedGoogle Scholar
  27. 27.
    Dusheiko G, et al (1994) Hepatology January: 13–18Google Scholar
  28. 28.
    Arita S, et al (1992) Transplant Proc 24: 1538–1540PubMedGoogle Scholar
  29. 29.
    Brunson ME, et al (1993) Transplantation 56: 1364–1367PubMedCrossRefGoogle Scholar
  30. 30.
    Pereira BJG, et al (1992) N Engl J Med 24: 910–915CrossRefGoogle Scholar
  31. 31.
    Chan T, et al (1994) Transplantation 58: 996–1000PubMedCrossRefGoogle Scholar
  32. 32.
    Roth D (1995) Am J Kidney Dis 25: 316CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • A. Rodrigues
    • 1
  • T. Morgado
    • 1
  • A. Castro Henriques
    • 1
  • A. Morais Sarmento
    • 1
  • M. Pereira
    • 1
  • S. Guimarãcs
    • 1
  1. 1.Department of Nephrology and Renal Transplant UnitHospital Geral Santo AntónioPortoPortugal

Personalised recommendations