Impact of HCV infection on first cadaveric renal transplantation, a single center experience

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Title:	Impact of HCV infection on first cadaveric renal transplantation, a single center experience
Authors:	林信宏(Hsin-Hung Lin);黃秋錦(Chiu-Ching Huang)*;黃俊源(Chun-Yuan Huang);楊智偉(Chih-Wei Yang);吳麥斯(Mai-Szu Wu);方基存(Ji-Tseng Fang);Yu CC(Yu CC);Chiang YJ(Chiang YJ)
Contributors:	中國附醫內科部腎臟科
Keywords:	hepatitis C virus;renal transplantation
Date:	2004-06
Issue Date:	2009-08-20 17:30:44 (UTC+8)
Abstract:	Background: Controversy still persists regarding the impact of HCV infection on renal transplant recipients. This study aimed to evaluate the effect of anti-HCV antibody status on patients and grafts of renal transplants at a single center. Methods: We examined 299 first cadaveric renal transplants performed between July 1981 and May 2000 at our hospital, including 129 patients with anti-HCV antibody positive (HCV+ group) and 170 patients with anti-HCV antibody negative (HCV− group). The HBsAg of the 299 patients were all negative throughout the follow-up period. Causes of graft failure and patient death were analyzed. Patient and graft cumulative survival were compared between HCV+ and HCV− groups. Multivariate analysis with Cox proportional hazard model were calculated for risk hazards of outcome. Results: Overall cumulative patient survival was 97.72, 85.63 and 71.31% at 1, 10, and 15 yr, respectively, in the HCV+ group, compared with 95.02, 67.85 and 59.83% at 1, 10 and 15 yr, respectively, in the HCV− group (p = 0.014). The major cause of patient death in both groups was infection with 26.67% in HCV+ group and 60.87% in HCV− group. Cumulative graft survival in the HCV+ group revealed 92.26, 55.97 and 26.16% at 1, 10 and 15 yr, respectively, compared with 88.07, 58.34 and 58.32% at 1, 10 and 15 yr, respectively, in the HCV− group (p = 0.700). The major cause of graft failure was chronic allograft dysfunction (56.82%) in HCV+ group, and patient death (32.43%) in the HCV− group. Multivariate analysis of patient survival revealed anti-HCV antibody+ had lesser risk hazard (aRR: 0.30, p = 0.002), chronic hepatitis had higher risk hazard (aRR: 1.90, p = 0.135), male recipient had higher risk hazard (aRR: 2.18, p = 0.051), and older recipients (age >55) also had higher risk hazard (aRR: 4.21, p = 0.063). Analysis of graft survival revealed only older donors (age >35) had higher risk hazard (aRR: 1.90, p = 0.081). Conclusions: The study revealed that patients with anti-HCV antibody had higher incidence of chronic hepatitis, chronic allograft dysfunction and post-transplantation nephrotic syndrome. Graft survival tended lower in the very long time. However, patients with anti-HCV antibodies had better patient survival when compared with patients without HCV antibodies up to 15 yr follow up. Patients of hepatitis C group without clinical chronic hepatitis was associated with best patient survival.
Relation:	CLINICAL TRANSPLANTATION18(3):261~266
Appears in Collections:	[China Medical University Hospital] Jurnal articles

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