Hepatitis C virus infection and kidney transplantation.
Hepatitis C virus (HCV) infection is an important problem in the patient with end-stage renal disease. After transplantation, liver disease is more frequent in HCV-positive patients than in HCV-negative patients. In the long run, this leads to important liver complications. The patients have a higher risk for developing proteinuria and infections. Long-term patient and graft survival rates are lower in HCV-positive patients than in HCV-negative graft recipients. Mortality is higher, mainly as a result of liver disease and infections. Despite this, transplantation is the best option for the HCV-positive patient with end-stage renal disease. Transplantation of HCV-positive kidneys should be offered to HCV-positive recipients in whom HCV RNA is detected in the serum. Finally, several measures after transplantation minimize the consequences of HCV infection. Adjustment of immunosuppression and careful follow-up in the outpatient clinic for early detection of proteinuria, infection, or worsening of liver disease are mandatory.
Renal Transplant Unit, Nephrology Department, Hospital Universitario 12 de Octubre, Barcelona, Spain. jmorales@h12o.es
José M
JM
Morales
Josep M
JM
Campistol
Beatriz
B
Dominguez-Gil
D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006526:Hepatitis C / Q000150:complications* / Q000517:prevention & control; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000601:surgery* / Q000821:virology; D016030:Kidney Transplantation; D006435:Renal Dialysis / Q000009:adverse effects