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Cryoglobulinemia in HCV-Positive Renal Transplant and Liver Transplant Patients

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HCV Infection and Cryoglobulinemia

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Abstract

Mixed cryoglobulinemia (MC) is a systemic disease that is often associated with hepatitis C virus (HCV) infection. In this chapter, we review the prevalence and consequences of MC in kidney (KTx) and liver (LTx) transplant recipients. The prevalence of cryoglobulinemia is quite high in maintenance KTx patients and is comparable to that observed in hemodialysis patients. In addition, cryoglobulinemia is often but not always associated with HCV infection. However, cryocrit levels tend to be lower in transplant patients than in non-renal-failure patients, which might explain why developing cryoglobulinemia after kidney transplantation rarely results in clinical symptoms, especially cryoglobulinemic syndrome. In LTx recipients, cryoglobulinemia occurs relatively frequently, i.e., in 19.5–30% of patients. In addition, cryoglobulinemia is often but not always associated with HCV infection and is more frequently symptomatic in LTx than in KTx patients, i.e., in 22–44% of LTx patients. When MC occurs after kidney or liver transplantation, dedicated treatment should be contemplated only in those patients who are symptomatic. Treatment is aimed at targeting HCV infection when present. In very rare cases, rituximab therapy may be of value.

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Authors and Affiliations

  1. Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, Toulouse, France

    Lionel Rostaing, Hugo Weclawiak & Nassim Kamar

  2. INSERM U563, IFR 30, CHU Purpan, Toulouse, France

    Lionel Rostaing

  3. INSERM U858/I2MR, Equipe 10, CHU Rangueil, Toulouse, France

    Nassim Kamar

Authors
  1. Lionel Rostaing
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  2. Hugo Weclawiak
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  3. Nassim Kamar
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Correspondence to Lionel Rostaing .

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Editors and Affiliations

  1. , Department of Internal Medicine and Clin, University of Bari, Piazza Giulio Cesare 11, Bari, 70124, Italy

    Franco Dammacco

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© 2012 Springer-Verlag Italia

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Rostaing, L., Weclawiak, H., Kamar, N. (2012). Cryoglobulinemia in HCV-Positive Renal Transplant and Liver Transplant Patients. In: Dammacco, F. (eds) HCV Infection and Cryoglobulinemia. Springer, Milano. https://doi.org/10.1007/978-88-470-1705-4_31

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  • DOI: https://doi.org/10.1007/978-88-470-1705-4_31

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  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1704-7

  • Online ISBN: 978-88-470-1705-4

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