Kidney graft survival in patients with hepatitis C: a single center experience.
Hepatitis C virus (HCV) infection is highly prevalent in renal transplant candidates; however, its effect on the transplant outcome is still controversial. The aim of the present study was to determine the effect of HCV infection in the outcome of kidney transplantation in a single transplant center. The study population 144 HCV- randomized selected patients and 64 HCV+ patients transplanted from 1973 to 2000, followed for up to 60 months post-transplantation. This retrospective study included the following variables: type of dialysis, time on renal replacement therapy, number of transfusions before and after transplantation, number of transplants, type of donor, immunosuppression, and rejection episodes. The Kaplan-Meier method was used to estimate graft and patient survival. Log-rank test was used to assess the difference in survival between HCV+ and HCV-. A multivariate Cox proportional hazards model was used to analyze the relation between graft and patient survival. HCV+ and HCV- patients had similar demographic and clinical characteristics; however, a higher number of HCV+ patients received blood transfusions after transplantation. Patient survival was not significantly different in 39 HCV+ and 96 HCV- patients transplanted with living-related donors (71% and 77% at five yr, respectively). Similarly, there was not significant difference in 25 HCV+ and 48 HCV- patients transplanted with kidneys from deceased donors, although there was a tendency to better outcome in HCV- patients (55% and 72% at five yr respectively). Regarding graft survival, there was also no differences in HCV+ and HCV- recipients of living-related grafts (61% and 66% at five yr post-transplant, respectively) and recipients of kidneys from deceased donors (44% and 41%, respectively). The results show that HCV+ patients can be transplanted with the same success than HCV- patients.
Arango
J
J
Grupo de Transplantes, Universidad de Antioquia, Hospital San Vicente de Paúl, Medellín, Colombia. jorlui@une.net.co
Arbelaez
M
M
Henao
J
J
Mejia
G
G
Arroyave
I
I
Carvajal
J
J
Garcia
A
A
Gutierrez
J
J
Velásquez
A
A
Garcia
L
L
Aguirre
C
C
D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D016572:Cyclosporine / Q000008:administration & dosage; D005260:Female; D006085:Graft Survival; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007674:Kidney Diseases / Q000453:epidemiology* / Q000601:surgery; D016030:Kidney Transplantation / Q000276:immunology*; D008103:Liver Cirrhosis / Q000453:epidemiology; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D008775:Methylprednisolone