Impact of anti-hepatitis C virus (HCV) antibody on outcomes in renal transplant recipients infected with HCV.
OBJECTIVE
Hepatitis C virus (HCV) infection remains an important risk factor for mortality and morbidity in transplant recipients. In this study, we retrospectively analyzed the impact of pretransplantation hepatitis C antibody status in HCV-infected renal allograft recipients on graft and patient survivals.


METHODS
From February 1998 to August 2007, 933 renal transplantations were performed at our center. Of these, 104 patients were identified to be harboring HCV infection: 59 (group I) were anti-HCV positive prior to transplantation and 45 (group II) were HCV RNA/antibody positive in the posttransplantation period. The patients transplanted in different eras received different immunosuppressive regimens. Complete follow-up data were available for 72.3% (43/59) in group I and 80% (36/45) in group II. Both groups had a similar number of patients on cyclosporine (62.8% vs 61.1%), tacrolimus (37.2% vs 38.8%), and mycophenolate mofetil (MMF; 58.1% vs 61.1%). These patients were analyzed for differences in patient and graft survivals by log-rank test.


RESULTS
The overall mean ages were 35.1 +/- 10.4 and 32.4 +/- 10.4 years, male to female ratios 37:6 and 31:5, mean donor ages 41.5 +/- 10.9 and 41.2 +/- 13.1 years, and mean follow-up durations 29.4 +/- 24 (range, 1-107.7) and 32.6 +/- 24.2 (range, 3.1-97.2) months in groups I and II, respectively. The patients in group I had received a significantly greater number of blood transfusions compared with patients in group II (6.2 +/- 5.7 vs 2.1 +/- 2.9) and a significantly greater number of dialysis treatments prior to transplantation (84.5 +/- 62.0 vs 33.8 +/- 43.2), respectively. Liver function tests--SGOT (22.6 +/- 16.1 vs 18.3 +/- 12.1 IU/L) and SGPT (24.2 +/- 28.9 vs 20.4 +/- 20.2 IU/L)-were similar in the 2 groups in the pretransplantation period, respectively. The patient and graft survivals at 5 years were similar: 88.6% vs 82.3% (P = .81) and 60.1% vs 62.5% (P = .75) in groups I and II, respectively. The serum creatinine values at last follow-up were 1.38 +/- 0.6 vs 1.7 +/- 2.4 mg% (P = not significant), SGOT 33.4 +/- 25.6 vs 38.3 +/- 47 IU/L, and SGPT 39.3 +/- 46.7 vs 59.2 +/- 89 IU/L in groups I and II, respectively. Liver decompensation occurred in 4 patients, 2 in each group at a mean duration of 36.5 months.


CONCLUSIONS
Absence of HCV antibody does not confer any survival disadvantage in HCV-infected renal allograft recipients undergoing renal transplantation.
Minz
M
M
Department of Transplant Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. mukutminz@hotmail.com
Sharma
A
A
Das
A
A
Chawla
Y
Y
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000914:Antibodies, Viral / Q000627:therapeutic use*; D001219:Aspartate Aminotransferases / Q000097:blood; D005260:Female; D006085:Graft Survival; D016174:Hepacivirus / Q000276:immunology*; D006526:Hepatitis C / Q000150:complications* / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D065227:Transfusion Reaction
D000914:Antibodies, Viral; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase