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Outcomes of Renal Allograft Recipients With Hepatitis C
R Carpio1, G E Pamugas1, R Danguilan1
1Department of Adult Nephrology, National Kidney and Transplant Institute, Quezon City, Philippines.
Insights
Hepatitis C virus (HCV) infection in kidney transplant patients did not significantly impact graft survival over 10 years. However, HCV-positive recipients showed a trend toward lower patient survival compared to HCV-negative individuals.
Area of Science:
- Nephrology
- Transplantation immunology
- Virology
Background:
- Hepatitis C virus (HCV) infection is linked to poorer outcomes in kidney transplant recipients.
- HCV is an independent risk factor for graft loss and mortality post-transplantation.
Purpose of the Study:
- To evaluate 10-year patient and graft survival in renal allograft recipients with HCV infection.
- Compare outcomes between HCV-positive and HCV-negative kidney transplant patients.
Main Methods:
- Retrospective analysis of kidney transplant recipients.
- Comparison between HCV-positive and HCV-negative patient groups.
- Data collected from inpatient and outpatient records.
Main Results:
- Patient survival was significantly lower in HCV-positive group (11 years 9 months) vs. HCV-negative group (12 years 10 months; P=.05).
- Graft survival showed no significant difference between HCV-positive (10 years 10 months) and HCV-negative (11 years 5 months) recipients (P=.734).
- Short- and long-term outcomes (rejection, renal function, proteinuria) were similar in both groups.
Conclusions:
- HCV infection did not significantly affect long-term graft survival in kidney transplant recipients.
- While patient survival was lower in HCV-positive patients, other key transplant outcomes remained comparable.
- HCV progression was noted in patients with detectable HCV-RNA pre-transplant.
Background:
Studies on the effect of hepatitis C virus (HCV) infection showed decreased graft survival compared to HCV-negative matched patients. It was also identified as an independent risk factor for graft loss and mortality in kidney transplantation patients.
Objective:
This study was designed to evaluate the 10-year graft and patient outcomes of renal allograft recipients with HCV infection at the National Kidney and Transplant Institute.
Methods:
This is a retrospective study of patients who underwent renal transplantation with HCV infection and a group who were HCV-negative in the same post-transplantation period. Data were gathered from the in-patient and out-patient clinic records.
Results:
Patient survival was significantly lower in the HCV-positive than in the HCV-negative group. The mean duration of patient survival was 154.95 (+4.95) months (12 years and 10 months) in HCV-negative patients compared to 141 (+6.52) months (11 years and 9 months) in the HCV-positive group (P = .05). Graft survival did not differ significantly between HCV-positive and HCV-negative recipients (P = .734). The mean duration of graft survival was 137 (+7.68) months (11 years and 5 months) in HCV-negative patients compared to 130 (+6.84) months (10 years and 10 months) in HCV-positive patients. Short- and long-term outcomes including biopsy-proven acute rejection, transplant glomerulopathy, chronic allograft nephropathy, renal function, and proteinuria were similar in both groups.
Conclusion:
Rejection, glomerulopathy, and renal function were similar in both groups. HCV progression was also observed in patients with detectable HCV-RNA 6 months before transplantation.
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