Viral hepatitis and kidney transplantation

Area of Science:

• Nephrology
• Hepatology
• Transplantation Immunology

Background:

• Hepatic dysfunction is a significant complication in renal transplant recipients.
• Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are primary causes of hepatitis in this population.
• Organ donor shortages prompt investigation into using HBV/HCV-infected kidneys.

Purpose of the Study:

• To evaluate the safety and outcomes of renal transplantation in HBV/HCV-infected recipients.
• To assess the feasibility of using kidneys from HBV/HCV-infected donors.
• To highlight the challenges and unresolved issues in managing hepatitis in renal transplant patients.

Main Methods:

• Review of existing literature on renal transplantation in HBV/HCV-infected patients and recipients of organs from infected donors.
• Analysis of short-term and long-term outcomes, including hepatic disorders, morbidity, mortality, and survival rates.
• Consideration of pharmacokinetic alterations of immunosuppressive drugs.

Main Results:

• Short-term outcomes for renal transplantation in HBV/HCV-infected recipients and recipients of infected kidneys are favorable.
• Long-term follow-up indicates an increased risk of hepatic disorders and poorer outcomes compared to uninfected cohorts.
• Survival rates for transplanted patients are superior to those who remain on dialysis with HBV or HCV infection.

Conclusions:

• Renal transplantation is a viable option for HBV/HCV-infected patients, offering better survival than dialysis.
• Transplant physicians and hepatologists must be vigilant for hepatitis complications, impacting patient morbidity/mortality and drug pharmacokinetics.
• Further research is crucial to address the complexities of hepatitis management in renal transplant recipients.