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Hepatitis B and renal transplantation.

D Scott¹, A Mijch, C R Lucas

¹Fairfield Infectious Diseases Hospital, Melbourne, Australia.

Transplantation Proceedings

|February 1, 1987

Summary

Renal transplant recipients who are Hepatitis B surface antigen positive (HBsAg+) have a low risk of liver disease progression. However, those infected post-transplant face significantly higher mortality, and HBeAg-positive individuals should not undergo transplantation.

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Area of Science:

Nephrology
Hepatology
Transplantation Immunology

Background:

Hepatitis B virus (HBV) infection poses risks in renal transplant recipients.
Understanding liver disease progression and mortality in HBsAg+ patients is crucial for transplant eligibility.

Purpose of the Study:

To evaluate the risk of progressive liver disease and mortality in HBsAg+ renal transplant recipients.
To identify subgroups of HBsAg+ patients with differential prognoses.

Main Methods:

Retrospective analysis of HBsAg+ patients undergoing renal transplantation.
Comparison of outcomes between chronic carriers and those with early post-transplant HBV acquisition.
Assessment of outcomes based on Hepatitis B e antigen (HBeAg) status.

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Main Results:

Renal transplantation in chronic HBsAg+ carriers showed a 7% mortality from liver disease.
HBsAg+ recipients with early post-transplant HBV acquisition experienced 60% mortality.
Persistently HBeAg-positive patients demonstrated a poor prognosis.

Conclusions:

Chronic HBsAg+ status at transplantation carries a relatively low risk of liver disease progression.
Early post-transplant HBV infection significantly increases mortality risk.
Renal transplantation should be contraindicated in persistently HBeAg-positive individuals due to poor outcomes.