Kazuaki Okino1, Yuki Okushi2, Kiyotaka Mukai2, Yuki Matsui2, Norifumi Hayashi2, Keiji Fujimoto2, Hiroki Adachi2, Hideki Yamaya2, Hitoshi Yokoyama3. 1. Department of Nephrology, Kanazawa Medical University School of Medicine, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan. taro1985@kanazawa-med.ac.jp. 2. Department of Nephrology, Kanazawa Medical University School of Medicine, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan. 3. Department of Nephrology, Kanazawa Medical University School of Medicine, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan. h-yoko@kanazawa-med.ac.jp.
Abstract
BACKGROUND: The impact of hepatitis C virus (HCV) infections on patient long-term survival after renal transplants is unclear. METHOD: To clarify the long-term outcomes of Japanese renal allograft recipients with HCV infections, we studied the cases of 187 patients (118 males and 69 females; 155 living donor cases, and 32 deceased donor cases; median follow-up period: 250 months) who underwent an initial renal transplant at Kanazawa Medical University from 1974 onwards. RESULT: In this cohort, 35 patients (18.7%) were HCV core antigen (Ag)-positive, and 13 of them (37.1%) died (due to liver cirrhosis (4 cases), hepatocellular carcinoma (1 case), fibrosing cholestatic hepatitis due to HCV (1 case), and infections complicated with chronic hepatitis (6 cases)). However, only 14 of the 145 (9.7%) recipients died in the HCV-Ag/HCV antibody (Ab)-negative group. The Kaplan-Meier life table method indicated that the HCV-infected group exhibited significantly lower patient and death-censored allograft survival rates (log-rank test; patient survival: Chi-square: 11.2, p = 0.004; graft survival: Chi-square: 25.7, p < 0.001). The survival rate of the HCV-Ag-positive recipients decreased rapidly at 240 months after the renal transplant procedure. In addition, a Cox proportional hazards model indicated that positivity for the HCV-Ag was the most important independent risk factor for post-renal transplant survival and allograft function [survival: hazard ratio (HR) 3.93 (1.54-10.03), p = 0.004; graft function: HR 2.09 (1.14-3.81), p = 0.016]. CONCLUSION: HCV infection is a harmful risk factor for patient survival (especially at ≥20 years post-renal transplant) and renal allograft function in allograft recipients.
BACKGROUND: The impact of hepatitis C virus (HCV) infections on patient long-term survival after renal transplants is unclear. METHOD: To clarify the long-term outcomes of Japanese renal allograft recipients with HCV infections, we studied the cases of 187 patients (118 males and 69 females; 155 living donor cases, and 32 deceased donor cases; median follow-up period: 250 months) who underwent an initial renal transplant at Kanazawa Medical University from 1974 onwards. RESULT: In this cohort, 35 patients (18.7%) were HCV core antigen (Ag)-positive, and 13 of them (37.1%) died (due to liver cirrhosis (4 cases), hepatocellular carcinoma (1 case), fibrosing cholestatic hepatitis due to HCV (1 case), and infections complicated with chronic hepatitis (6 cases)). However, only 14 of the 145 (9.7%) recipients died in the HCV-Ag/HCV antibody (Ab)-negative group. The Kaplan-Meier life table method indicated that the HCV-infected group exhibited significantly lower patient and death-censored allograft survival rates (log-rank test; patient survival: Chi-square: 11.2, p = 0.004; graft survival: Chi-square: 25.7, p < 0.001). The survival rate of the HCV-Ag-positive recipients decreased rapidly at 240 months after the renal transplant procedure. In addition, a Cox proportional hazards model indicated that positivity for the HCV-Ag was the most important independent risk factor for post-renal transplant survival and allograft function [survival: hazard ratio (HR) 3.93 (1.54-10.03), p = 0.004; graft function: HR 2.09 (1.14-3.81), p = 0.016]. CONCLUSION:HCV infection is a harmful risk factor for patient survival (especially at ≥20 years post-renal transplant) and renal allograft function in allograft recipients.
Authors: Y Kokado; S Takahara; N Ichimaru; K Toki; J D Wang; S Permpongkosol; S Sagawa; Y Ichikawa; T Akiyama; N Yoshimura; A Okuyama Journal: Transplant Proc Date: 2000-11 Impact factor: 1.066
Authors: P Mathurin; C Mouquet; T Poynard; C Sylla; H Benalia; C Fretz; V Thibault; J F Cadranel; B Bernard; P Opolon; P Coriat; M O Bitker Journal: Hepatology Date: 1999-01 Impact factor: 17.425
Authors: J Izopet; L Rostaing; K Sandres; J M Cisterne; C Pasquier; J L Rumeau; M Duffaut; D Durand; J Puel Journal: J Infect Dis Date: 2000-03 Impact factor: 5.226
Authors: M A Gentil; J L Rocha; G Rodríguez-Algarra; P Pereira; R López; G Bernal; J Muñoz; M Naranjo; J Mateos Journal: Nephrol Dial Transplant Date: 1999-10 Impact factor: 5.992