title: Liver-kidney recipients with chronic viral hepatitis C treated with interferon-alpha.
abstract: Antiviral therapy with interferon-alpha (IFN-alpha) and pegylated IFN-alpha (PEG-IFN-alpha) for chronic hepatitis C (HCV)-infected kidney recipients remains controversial. IFN-alpha is not recommended in most cases because it induces severe acute graft rejection. However, IFN-alpha, as PEG-IFN-alpha, is associated with a more pronounced immune response, and is well tolerated in HCV-infected liver recipients without causing graft rejection. In combined liver-kidney transplant (LKT) recipients, IFN-alpha has been occasionally used and appears to be well tolerated. All LKT recipients with a functioning kidney and liver having a HCV replication and who needed IFN-alpha therapy have been included in the study. The occurrence of liver and/or renal acute rejection as well as the HCV replication has been collected. A total of 12 LKT patients treated with PEG-IFN-alpha plus ribavirin have been studied. No acute rejection was observed. Renal function remained stable during and after discontinuing treatment, without any graft dysfunction. Two patients had a partial viral response and four had a sustained viral response. All patients, whatever their viral response, had decreased liver-enzyme levels. Response to PEG-IFN-alpha therapy was correlated with steroid dose and transaminase level when PEG-IFN-alpha was started. These data suggest that the combination therapy of PEG-IFN-alpha plus ribavirin did not have a higher risk of acute kidney-graft rejection after liver-kidney transplantation.
authors.affiliation: IFRNT, Nephrology and Transplantation Unit, Bicêtre Hospital, Le Kremlin Bicêtre, France.
authors.forename: Qussai
authors.initials: Q
authors.lastname: Hassan
authors.forename: Bruno
authors.initials: B
authors.lastname: Roche
authors.forename: Camille
authors.initials: C
authors.lastname: Buffet
authors.forename: Thomas
authors.initials: T
authors.lastname: Bessede
authors.forename: Didier
authors.initials: D
authors.lastname: Samuel
authors.forename: Bernard
authors.initials: B
authors.lastname: Charpentier
authors.forename: Antoine
authors.initials: A
authors.lastname: Durrbach
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D006084:Graft Rejection; D006526:Hepatitis C / Q000276:immunology* / Q000821:virology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016898:Interferon-alpha / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000379:methods*; D008099:Liver / Q000473:pathology; D017093:Liver Failure / Q000628:therapy* / Q000821:virology; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D051437:Renal Insufficiency / Q000628:therapy* / Q000821:virology; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D013256:Steroids / Q000627:therapeutic use; D000637:Transaminases / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016898:Interferon-alpha; D013256:Steroids; D012254:Ribavirin; D000637:Transaminases