Kidney transplantation from donors with viral B and C hepatitis.
BACKGROUND
The success of renal transplantation as a treatment for end-stage renal disease has created a chronic shortage of donor organs. We present our experience in transplanting kidneys from donors with hepatitis B virus (HBV) or hepatitis C virus (HCV) among matched serology-positive recipients.


METHODS
From January 2002 to November 2005, 44 patients with end-stage renal disease and HCV seropositivity underwent kidney transplantation. In 28 transplants in HCV+ recipients, the donor was HCV+ (DC+/RC+) and in 16 of these cases the donor (one living donor) was HCV- (DC-/RC+). In the same period 14 patients with HBV infection and HbsAg seropositivity underwent kidney transplantation: eight received their graft from a cadaveric HbsAg-positive donor (DB+/RB+), while six patients received their graft from an HbsAg-negative donor.


RESULTS
Viral reactivation was higher among DC+/RC+ (21.4%) than DC-/RC+ patients (6%). Graft survivals were 90% and 88% for DC+/RC+ and DC-/RC+, respectively; patient survivals were 100% for DC+/RC+ and 94% for DC-/RC+. Among the group of DB+/RB+, all the patients developed an HBV-DNA positivity in the early postoperative period. Patient and graft survivals were 100% in both groups.


CONCLUSIONS
Our results suggest that HBV- and HCV-positive donors can be considered as an alternative donor source, because their kidneys are allocated to the matched serology-positive recipients, shortening their time on the waiting list.
Veroux
P
P
Department of Surgery, Transplantation and Advanced Technologies, Organ Transplant Unit, University Hospital, Catania, Italy. veroux@unict.it
Veroux
M
M
Sparacino
V
V
Giuffrida
G
G
Puliatti
C
C
Macarone
M
M
Fiamingo
P
P
Cappello
D
D
Gagliano
M
M
Spataro
M
M
Di Mare
M
M
Cannizzaro
M A
MA
Severino
V
V
D000328:Adult; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D016174:Hepacivirus / Q000254:growth & development / Q000302:isolation & purification; D006509:Hepatitis B / Q000150:complications*; D006515:Hepatitis B virus / Q000254:growth & development / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000302:isolation & purification; D016019:Survival Analysis; D014019:Tissue Donors / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014779:Virus Replication
D004279:DNA, Viral; D012367:RNA, Viral