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Chronic hepatitis in kidney allograft recipients
Lancet (London, England)
|April 14, 1990
Summary
Renal transplantation is suitable for kidney patients with chronic liver disease, regardless of Hepatitis B surface antigen (HBsAg) status. Outcomes for HBsAg-positive and negative recipients were comparable, indicating HBV status doesn't preclude transplantation.
Area of Science:
- Nephrology
- Hepatology
- Transplantation Medicine
Background:
- Chronic liver disease is a concern in kidney transplant candidates.
- Hepatitis B virus (HBV) infection, indicated by Hepatitis B surface antigen (HBsAg), can affect liver health.
- The impact of renal transplantation on chronic liver disease and vice versa needs evaluation.
Purpose of the Study:
- To assess the effects of renal transplantation on chronic liver disease in HBsAg-positive and HBsAg-negative kidney recipients.
- To compare patient and allograft survival rates between HBsAg-positive and HBsAg-negative groups.
- To investigate the role of chronic alcohol consumption in liver disease among kidney transplant recipients.
Main Methods:
- Comparison of 98 HBsAg-positive and 31 HBsAg-negative kidney recipients.
- Diagnosis of chronic liver disease through liver biopsy analysis.
- Semiquantitative evaluation of histological features of chronic hepatitis.
- Examination of serial liver biopsy specimens.
- Actuarial analysis of patient and allograft survival.
Main Results:
- Chronic liver disease developed in 88% of HBsAg-positive and 4% of HBsAg-negative recipients with normal baseline liver function.
- Liver abnormalities included chronic persistent hepatitis (32%), chronic active hepatitis (51%), and cirrhosis (17%) in HBsAg-positive patients.
- Patient survival rates were 78% (HBsAg-positive) and 87% (HBsAg-negative).
- Allograft survival rates were 64% (HBsAg-positive) and 71% (HBsAg-negative).
- Chronic alcohol consumption was more prevalent in patients with chronic liver disease, irrespective of HBV status.
Conclusions:
- Renal transplantation appears appropriate for hemodialysis patients with chronic hepatitis, irrespective of their Hepatitis B virus (HBV) status.
- Hepatitis B surface antigen (HBsAg) status did not significantly impact patient or allograft survival post-transplantation.
- Chronic liver disease management and alcohol consumption should be considered in kidney transplant recipients.