Long-term outcome in kidney transplant patients with hepatitis C (HCV) infection

S. L. Orloff, C. A. Stempel, T. L. Wright, S. J. Tomlanovich, J. C. Amend, P. G. Stock, J. S. Melzer, F. Vincenti

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Abstract

To assess the prevalence and long-term impact of HCV on kidney transplant recipients, we assayed 716 pre-transplant sera using a first-generation ELISA. The anti-HCV positive sera were confirmed by a 6-antigen radioimmunoassay (RIA). Patients were followed up for 5 years. Graft survival, function, evidence of chemical hepatitis (AST > 2 X normal), patient mortality and cause of death were evaluated. The prevalence of anti-HCV antibody was 10.3%. In the 638 patients who were followed up for 5 years, there were no differences in graft function, graft survival, overall mortality, or death from sepsis or liver disease. Peak AST levels were significantly higher in anti-HCV positive patients compared to anti-HCV negative patients. At 5 years, the AST levels remained significantly higher in the anti-HCV positive group, however, this was only 6 U/l > normal. Liver biopsies performed 3 to 7 years post-transplant in 80% of anti-HCV positive patients with chemical hepatitis showed 12% CAH, 50% mild hepatitis and 38% normal histology. Six (9.7%) patients seroconverted from anti-HCV positive to anti-HCV negative 2 to 5 years post-transplant. The presence of anti-HCV does not appear to alter long-term patient or graft survival, and histologic evidence of severe chronic liver disease was rare in anti-HCV positive patients with chemical hepatitis. From these results, the presence of anti-HCV antibody should not preclude kidney transplantation.

Original languageEnglish (US)
Pages (from-to)119-124
Number of pages6
JournalClinical Transplantation
Volume9
Issue number2
StatePublished - Jan 1 1995

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Keywords

  • Hepatitis C infection
  • Kidney transplantation

ASJC Scopus subject areas

  • Transplantation

Cite this

Orloff, S. L., Stempel, C. A., Wright, T. L., Tomlanovich, S. J., Amend, J. C., Stock, P. G., Melzer, J. S., & Vincenti, F. (1995). Long-term outcome in kidney transplant patients with hepatitis C (HCV) infection. Clinical Transplantation, 9(2), 119-124.