Short and long term outcome of kidney transplanted patients with chronic viral hepatitis B and C.
BACKGROUND
Liver disease related to chronic viral hepatitis is a major cause of morbidity and mortality in renal transplant patients. There is no agreement upon the influence of chronic hepatitis B (HBV) and hepatitis C (HCV) infection in patient and graft survival.


OBJECTIVE
The aim of the study was to evaluate the influence of HBV and HCV on patient and graft short and long term survival, in the patients transplanted at our institution.


METHODS
We evaluated the influence of antiHCV and HBsAg status (positive vs. negative); sex; age (> 49 years vs. < 49 years at transplantation); time on dialysis (> 3 vs. < 3 years); acute rejection; kind of graft (deceased vs. living donor, and kidney versus kidney and pancreas); number of transplantations; use of induction immunosuppression; and maintenance immunosuppression treatment (comparing the traditional triple therapy containing azathioprine, cyclosporine and prednisone vs. newer regimens which include tacrolimus, mycophenolate mofetil, sirolimus, etc) on the survival, long term and within the first month of transplantation, of the graft and the patients transplanted in our Institution between January 1991 and August 2009.


RESULTS
We included 542 patients, 60% males. median age of 42.03 years (SD 13.06 years). 180 patients (33%) were antiHCV positive and 23 (4%) were HBsAg positive. AntiHCV positive, traditional triple therapy and acute rejection were associated with diminished graft survival. Older age, antiHCV positive, HBsAg positive, deceased donor, kidney-pancreas transplantation and traditional triple therapy were associated with diminished patient survival. Traditional triple therapy was associated with diminished one month graft survival; and older age and antiHCV positive were associated with diminished one month patient survival.


CONCLUSIONS
In our experience, antiHCV positive status was associated with diminished long term patient and graft survival, and diminished six month graft survival; and HBsAg positive was associated with diminished patient survival.
Ridruejo
Ezequiel
E
Nephrology Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas .Norberto Quirno. (CEMIC). eridruejo@gmail.com
Díaz
Carlos
C
Michel
Mario Dávalos
MD
Soler Pujol
Gervasio
G
Martínez
Alfredo
A
Marciano
Sebastián
S
Mandó
Oscar G
OG
Vilches
Antonio
A
D000208:Acute Disease; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy / Q000401:mortality; D006085:Graft Survival; D019694:Hepatitis B, Chronic / Q000401:mortality*; D019698:Hepatitis C, Chronic / Q000401:mortality*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D006435:Renal Dialysis / Q000706:statistics & numerical data; D016019:Survival Analysis; D016896:Treatment Outcome
D007166:Immunosuppressive Agents