Hepatitis antigenemia and survival after renal transplantation.
Some transplant programs regard hepatitis B antigenemia (HBsAg+) as a contraindication to renal transplantation. We studied the records of 13,287 renal transplant recipients, 781 (5.88%) who were positive for HBsAg, the remainder negative (HBsAg-). Patient survival for HBsAg-recipients is 91.8% at 1 year, 80.6% at 5 years, and 65.8% at 10 years. Patient survival for HBsAg+ recipients was 88.8% at 1 year, 77.6% at 5 years, and 61.6% at 10 years. The difference in patient survival was 3-4%, and graft survival was nearly constant at 3%. The statistical significance for patient survival was p = 0.02 by the log-rank test and p = 0.007 by the Wilcoxon test. There is far more statistical power (p = 0.0001) in other risk factors such as transplant number, recipient race, recipient age, and diabetes. Currently available diagnostic studies may allow better risk stratification of HBsAg+ candidates. We believe that hepatitis antigenemia without added and related risk factors has only a mild effect on graft and patient outcome.
Pfaff
W W
WW
Department of Surgery, University of Florida College of Medicine, Gainesville, USA.
Blanton
J W
JW
D000206:Actuarial Analysis; D000367:Age Factors; D000075202:Contraindications; D003920:Diabetes Mellitus / Q000601:surgery; D005500:Follow-Up Studies; D006085:Graft Survival; D006509:Hepatitis B / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology / Q000706:statistics & numerical data; D016014:Linear Models; D015999:Multivariate Analysis; D012044:Regression Analysis; D012086:Reoperation / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D044465:White People
D006514:Hepatitis B Surface Antigens