Pretransplant interferon prevents hepatitis C virus-associated glomerulonephritis in renal allografts by HCV-RNA clearance.
The purpose of this study was to examine the effect of pretransplant interferon administration on the occurrence of post-transplant de novo glomerulonephritis in hepatitis C virus (HCV)-positive renal allografts. From December 1992 to December 2000, 78 HCV-positive patients received a renal allograft in our unit. Fifteen out of 78 received pretransplant interferon for 1 year. Hepatitis C virus was investigated by serology and qualitative polymerase chain reaction (PCR). Hepatitis C virus-related de novo glomerulonephritis (membranoproliferative or membranous) was suggested by proteinuria (>1.5 g/24 h) and/or microhematuria and always diagnosed by renal biopsy. Of 15 HCV-positive recipients who received pretransplant interferon, 10 (67%) became HCV-RNA negative at the time of transplantation and only one out of the 15 (6.7%) developed de novo glomerulonephritis (this patient was HCV-RNA positive at transplantation). Among non-interferon-treated allograft recipients, 28.7% had negative HCV-RNA and 12 out of 63 (19%) developed de novo glomerulonephritis (9, membranoproliferative; 3 membranous), all 12 having positive HCV-RNA at transplantation (p < 0.0001). In conclusion, pretransplant interferon may reduce the occurrence of post-transplant HCV-related de novo glomerulonephritis. Our results suggest that the indication for pretransplant interferon should be extended to treat all HCV-RNA positive candidates for renal transplantation.
Cruzado
Josep M
JM
Nephrology Department, Hospital de Bellvitge, Department of Medicine, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
Casanovas-Taltavull
Teresa
T
Torras
Joan
J
Baliellas
Carme
C
Gil-Vernet
Salvador
S
Grinyó
Josep M
JM
D000328:Adult; D005260:Female; D005921:Glomerulonephritis / Q000517:prevention & control* / Q000821:virology*; D006085:Graft Survival / Q000502:physiology; D016174:Hepacivirus / Q000378:metabolism*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000628:therapy; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control* / Q000821:virology*; D012313:RNA / Q000378:metabolism; D013997:Time Factors; D019172:Transplantation Conditioning
D016898:Interferon-alpha; D012313:RNA