Long-term effect of hbs antigenemia on patient survival after renal transplantation

We studied 121 renal-graft recipients to delineate the effects of HBs antigenemia on patient and graft survival. Grafts had functioned for at least six months; follow-up periods averaged 37 months. Mortality was significantly higher (P less than 0.05) in the HBs Ag-positive (17 deaths among 61 patients) than in the HBs Ag-negative group (eight of 60 patients). Patient and graft survivals, from six months onwards, were significantly lower at four years in the positive (64 and 60 per cent respectively) than in the negative group (87 and 80 per cent respectively). These differences resulted solely from a fivefold increase in mortality from liver disease in the positive group and were unrelated to graft rejection. HBs antigenemia did not improve graft tolerance during the first 24 months in 129 patients in whom repeated HBs Ag determinations had been obtained before operation. We conclude that HBs antigenemia has an unfavorable effect on transplant and patient survival.