Hepatitis C and renal transplantation.

Area of Science:

• Nephrology
• Hepatology
• Transplantation Medicine

Background:

• Hepatitis C is more prevalent in hemodialysis patients, reducing survival for dialysis and transplant recipients.
• Kidney transplantation offers a survival benefit compared to continued dialysis for patients with chronic hepatitis C.

Purpose of the Study:

• To emphasize kidney transplantation as the preferred treatment for end-stage renal disease patients with hepatitis C.
• To highlight the need for appropriate patient selection and workup guidelines.
• To discuss the role of liver biopsy and donor selection in managing these patients.

Main Methods:

• Review of current literature and clinical practices regarding hepatitis C in kidney transplant candidates.
• Emphasis on liver biopsy for fibrosis assessment and post-transplant management.
• Evaluation of safety and efficacy of transplanting hepatitis C-positive donor kidneys to positive recipients.

Main Results:

• Kidney transplantation is the treatment of choice, offering survival advantages over dialysis.
• Liver biopsy is essential for staging fibrosis and guiding post-transplant care.
• Transplanting hepatitis C-positive donor kidneys to positive recipients is safe and reduces waiting times.

Conclusions:

• Kidney transplantation should be considered for end-stage renal disease patients with hepatitis C, with careful selection.
• Liver biopsy is critical for assessing fibrosis and managing post-transplant care.
• Simultaneous kidney/liver transplantation may be indicated for patients with advanced liver disease.