Clinical outcome of renal transplantation in end-stage renal disease patients with positive pretransplantation hepatitis B surface antigen.
BACKGROUND
Renal transplantation (RTx) is the best therapeutic modality for patient suffering from end-stage renal disease (ESRD) with positive pretransplantation hepatitis B surface antigen (HbsAg). We report 11 years of single-center experience on RTx vis-à-vis patient/graft survival, graft function in terms of serum creatinine (SCr), and rejection episodes in 35 ESRD patients with pretransplantation HbsAg positivity.


METHODS
Thirty-five ESRD patients with pretransplantation HbsAg positivity underwent RTx at our center between 2000 and 2010. Mean recipient age was 36.06 ± 12.22 years; 30 were males and 5 were females. Mean donor age was 43.51 ± 13.63 years; 13 were males and 22 were females. The majority of donors were parents (31.42%) and spouses (22.85%). Mean HLA match was 2 ± 1.37. The most common recipient diseases leading to ESRD were chronic glomerulonephritis (51%) and diabetes (17.5%). Posttransplantation immunosuppression consisted of a calcineurin inhibitor-based regimen.


RESULTS
Over mean follow-up of 6.16 ± 3.69 years, patient and graft survival rates were 71.42% and 71.42%, respectively, with mean SCr of 1.92 ± 0.62 mg% with 20% biopsy-proven acute rejection episodes. In total, 10 (28.57%) patients were lost, mainly to infections.


CONCLUSIONS
RTx for ESRD with pretransplantation HbsAg positivity has acceptable graft function and patient/graft survival over 11 years follow-up and should be encouraged.
Department of Nephrology and Clinical Transplantation, Laboratory Medicine, Transfusion Services and Immunohematology, Institute of Kidney Diseases and Research Center, Dr HL Trivedi Institute of Transplantation Sciences, Ahmedabad, India. drhvpatel@gmail.com
H V
HV
Patel
V B
VB
Kute
A V
AV
Vanikar
P R
PR
Shah
M R
MR
Gumber
S H
SH
Jain
D P
DP
Engineer
G H
GH
Ghelani
H L
HL
Trivedi
D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007194:India; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D015415:Biomarkers; D006514:Hepatitis B Surface Antigens; D007166:Immunosuppressive Agents