Outcome of renal transplantation in hepatitis BsAg-positive patients.
Renal transplantation of patients with previous or ongoing hepatitis B virus infection has been tempered with a concern that immunosuppression may lead to viral replication and progressive liver damage. However, renal transplantation as therapy for end-stage renal failure in these patients improves quality of life and reduces the risk of body fluid exposure to their carers. To assess the long-term outcome of renal transplantation in hepatitis-BsAg-positive patients a retrospective study was carried out on the patients transplanted in this unit since 1969. Seventy-six patients received 98 grafts up to December 1991; follow-up was available on 68. Thirty-one of the 68 patients died; the causes of death were infective 23, cardiovascular 6, liver failure 4, pancreatitis 2, aspiration 1, GI haemorrhage 1, and stopped therapy 1. Serological markers of hepatitis B virus infection did not correlate with outcome. The risk of developing liver failure after renal transplantation appears small in the hepatitis-BsAg-positive patients and no patient should be denied a renal transplant on the basis of serological tests.
Nelson
S R
SR
Department of Renal Medicine, King's College Hospital, Denmark Hill, London, UK.
Snowden
S A
SA
Sutherland
S
S
Smith
H M
HM
Parsons
V
V
Bewick
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000276:immunology*; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects; D017093:Liver Failure / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
D006514:Hepatitis B Surface Antigens