Hepatitis C infection in potential recipients with normal liver biochemistry does not preclude renal transplantation.
The hepatitis C virus (HCV) may be an important cause of chronic liver disease in renal transplant recipients. We investigated retrospectively the incidence and outcome of HCV infection in long-term renal transplant recipients and patients on hemodialysis. Stored, pretransplant sera of transplant recipients with normal liver biochemistry at surgery were tested for hepatitis C by a second-generation enzyme immunoassay. Hemodialysis patients were tested by a first-generation enzyme-linked immunosorbent assay (ELISA) against c100-3. We studied 252 renal transplant recipients and 58 hemodialysis patients followed for 65 +/- 10 months and 26 +/- 6 months, respectively. Fifteen percent (38/252) of the transplant recipients were HCV positive as were 3/58 (5%) of the hemodialysis patients. Overt liver disease occurred in 22/252 (8.7%) transplant recipients and none in the hemodialysis group. Thirty-six percent (8/22) of transplant recipients with overt liver disease were HCV positive. No HCV-positive patients died of liver failure. Of six biopsies in the HCV-positive transplant group, two had histological evidence of CAH. CAH was seen in six of eight biopsies in the HCV-negative transplants and two of these latter patients progressed to cirrhosis. No hemodialysis patients had clinical or histological evidence of chronic liver disease. Two HCV-negative transplant patients died of liver failure, while no deaths related to liver disease occurred in hemodialysis patients regardless of HCV status. We conclude that hepatitis C may cause chronic hepatitis in renal transplant patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Kazi
S
S
Department of Medicine, University of Illinois at Chicago 60612-7213.
Prasad
S
S
Pollak
R
R
Holzer
T
T
Heynen
C
C
Fabrega
A J
AJ
Pitrak
D
D
Layden
T J
TJ
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002908:Chronic Disease; D000075202:Contraindications; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016174:Hepacivirus / Q000276:immunology; D006508:Hepatitis Antibodies / Q000032:analysis; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D018937:Hepatitis C Antibodies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery; D016030:Kidney Transplantation; D008099:Liver / Q000378:metabolism*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies
D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin