title: Characteristics of hepatitis C in renal transplant candidates.
abstract: OBJECTIVE
  To characterize hepatitis C in renal transplant candidates and to compare hepatitis C-related liver disease between patients with end-stage renal disease (ESRD) and well-matched control subjects without renal disease.
  
  
  BACKGROUND
  Hepatitis C is common in dialysis patients and can cause morbidity and mortality in renal transplant recipients. Patients with advanced hepatitis C often are excluded from renal transplantation.
  
  
  METHODS
  Forty-six renal transplant candidates and 46 control subjects matched for age, sex, and race without renal disease were included. Demographic, laboratory, and histologic data were compared between patients with ESRD and control subjects.
  
  
  RESULTS
  Alanine aminotransferase levels were significantly lower in patients with ESRD (p < 0.001). Hepatitis C virus RNA levels were similar between groups. Patients with ESRD had less inflammatory activity (p < 0.001) and a lower proportion of bridging fibrosis or cirrhosis (13%) than control subjects (30%, p = 0.043). Clinical and laboratory features did not predict histologic grade or stage of hepatitis C in patients with ESRD. Two complications of percutaneous liver biopsy occurred per three diagnoses of cirrhosis in patients with ESRD. No complications occurred with transjugular liver biopsy in this group.
  
  
  CONCLUSIONS
  Patients with ESRD had less severe hepatitis C than did control subjects. Clinical measurements did not predict histologic findings in renal transplant candidates. Transjugular liver biopsy should be considered to stage hepatitis C in renal transplant candidates due to the risk of percutaneous biopsy in uremic patients.
authors.affiliation: Department of Medicine, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612, U.S.A. scotler@rush.edu
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Cotler
authors.forename: Gloria
authors.initials: G
authors.lastname: Diaz
authors.forename: Sushama
authors.initials: S
authors.lastname: Gundlapalli
authors.forename: Shiram
authors.initials: S
authors.lastname: Jakate
authors.forename: Anshuman
authors.initials: A
authors.lastname: Chawla
authors.forename: Deepak
authors.initials: D
authors.lastname: Mital
authors.forename: Steven
authors.initials: S
authors.lastname: Jensik
authors.forename: Donald M
authors.initials: DM
authors.lastname: Jensen
mesh_terms: D000328:Adult; D001706:Biopsy / Q000009:adverse effects / Q000379:methods; D016022:Case-Control Studies; D005260:Female; D006526:Hepatitis C / Q000150:complications / Q000473:pathology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D016030:Kidney Transplantation; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged