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Treatment of HBV and HCV seropositive patients after renal transplantation
liuhua 1 #,Xue Wujun 2 *,Tian Puxun 2,Ding Xiaoming 2,Feng Xinshun 2
1.Nephropathy Center, the First Affiliated Hospital , Xi’an Jiaotong University School of Medicine, Xi’an, Shaanxi 710061, China
2.Department of Renal Transplantation of Nephropathy Center, The First Affiliated Hospital，Xi’an Jiaotong University School of Medicine,
*Correspondence author
#Submitted by
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Funding: 国家自然科学基金,高等学校博士点专项科研基金（No.30571799,20050698038）
Opened online:10 February 2009
Accepted by: none
Citation: liuhua,Xue Wujun,Tian Puxun.Treatment of HBV and HCV seropositive patients after renal transplantation[OL]. [10 February 2009] http://en.paper.edu.cn/en_releasepaper/content/28744
 
 
Backgroud/Purpose. There are higher incidence of hepatitis virus infection in renal transplant patients. In present study, we evaluated the risk and investigate the effect of integrative treatment on renal transplant patients with hepatitis B surface antigen (HBsAg) and/or seropositivity for anti-hepatitis C virus (HCV) antibody. Methods. A total of 79 HBsAg-positive and/or anti-HCV-positive patients underwent transplantation (78 kidney, one kidney and liver) between 2000 and 2007. After renal transplantation, patients with liver dysfunction received integrative therapy, including adjustment of dosage and/or type of immunosuppressants, and hepatic protection depending on the extent of the liver dysfunction. Hepatitis B virus (HBV)-DNA-positive patients were treated with lamivudine to inhibit viral replication. Results. On review of the total programme, 40 patients (50.63%) experienced liver dysfunction in the first 2 months post-operation, and five (6.33%) of these patients were HBV-DNA or HCV-RNA positive. The liver dysfunction rate was 26.09% in patients treated with tacrolimus/ mycophenolate mofetil (MMF)/prednisone (Pred), and was 60.71% in those treated with cyclosporine/MMF/Pred (P<0.05). After integrative therapy, the liver function of 36 (90%) patients was restored to normal. At the last follow-up, the survival rate of the patients and grafts was 98.48/98.48%, 92.31/92.31% and 89.26/85.71% at 1, 3 and 5 years, respective1y. Conclusion. These data suggest that timely hepatic protection and anti-viral treatment and appropriate adjustment of immunosuppressant dosage and/or type may improve the survival rate of renal transplant patients who are positive for hepatitis virus.
Keywords:hepatitis B virus;hepatitis C virus;infection;renal transplantation;treatment
 
 
 

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