Association of graft survival with host response to hepatitis B infection in patients with kidney transplants.
We studied the relation of host response to hepatitis B infection before transplantation with survival of kidney grafts in 79 patients receiving 87 transplants. Antibody to hepatitis B surface antigen (anti-HBs) signaled early graft rejection (median survival congruent to two months), whereas hepatitis B surface antigen (HBsAg) signaled delayed rejection (greater than 22 months). Patients with neither HBsAg nor anti-HBs had graft survival times (median congruent to 16 months) similar to the HBsAg carriers but significantly longer than the anti-HBs-positive patients (p less than 0.01). Similar results were observed when patients who received HLA-identical kidneys or had anti-HLA antibodies before transplantation were excluded. The highest probability of graft rejection was in patients with anti-HBs who received kidneys from male donors. The probability that such grafts would survive for four months was less than 20 per cent. HLA-nonidentical kidneys transplanted into patients with anti-HBs have a poor prognosis, whereas such grafts in HBsAg carriers have as good a prognosis as grafts in uninfected recipients.
D000914:Antibodies, Viral / Q000032:analysis; D002353:Carrier State / Q000276:immunology; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006680:HLA Antigens; D006509:Hepatitis B / Q000209:etiology / Q000276:immunology*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D011183:Postoperative Complications; D012737:Sex Factors; D013997:Time Factors; D014019:Tissue Donors; D014184:Transplantation, Homologous
D000914:Antibodies, Viral; D006680:HLA Antigens; D006514:Hepatitis B Surface Antigens