Clinicopathologic course of hepatitis B infection in surface antigen carriers following living-related renal transplantation.
We present the clinical course, serology, and histopathology of 17 living-related renal allograft recipients who were hepatitis B surface antigen (HBsAg) positive at the time of transplantation. Although 14 patients were hepatitis B e antigen (HBeAg) positive, none had clinical hepatitis at the time of transplantation. All patients were receiving moderate doses of prednisolone and azathioprine only. At the mean short-term follow-up of 70 months (range, 6 to 132 months), none of the patients had seroconversion to antibody to HBsAg. Four patients died due to extrahepatic complications between 16 and 50 months following transplantation. Of these, three had normal liver function at the time of death and one had portal tract infiltration by chronic inflammatory cells. One patient died due to fulminant hepatitis at 6 months after transplantation. Of the remaining 12 patients, although 11 were HBeAg positive, only two developed chronic active hepatitis. Our short-term follow-up data suggest that chronic liver disease is not a frequent complication following living-related renal transplantation in HBsAg carriers. In addition, the presence of HBeAg at the time of transplantation does not predict a bad prognosis. Thus, in a living-related renal transplant program, asymptomatic carriers of HBsAg with positive HBeAg are not a contraindication for renal transplantation.
Agarwal
S K
SK
Department of Nephrology, All India Institute of Medical Sciences, New Delhi.
Dash
S C
SC
Tiwari
S C
SC
Mehta
S N
SN
Saxena
S
S
Malhotra
K K
KK
D000206:Actuarial Analysis; D000328:Adult; D002353:Carrier State / Q000276:immunology*; D005260:Female; D006085:Graft Survival; D006509:Hepatitis B / Q000276:immunology*; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods; D008297:Male; D013997:Time Factors
D006514:Hepatitis B Surface Antigens