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Hepatitis C infection in potential recipients with normal liver biochemistry does not preclude renal transplantation

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Abstract

The hepatitis C virus (HCV) may be an important cause of chronic liver disease in renal transplant recipients. We investigated retrospectively the incidence and outcome of HCV infection in long-term renal transplant recipients and patients on hemodialysis. Stored, pretransplant sera of transplant recipients with normal liver biochemistry at surgery were tested for hepatitis C by a second-generation enzyme immunoassay. Hemodialysis patients were tested by a first-generation enzyme-linked immunosorbent assay (ELISA) against c100-3. We studied 252 renal transplant recipients and 58 hemodialysis patients followed for 65±10 months and 26±6 months, respectively. Fifteen percent (38/252) of the transplant recipients were HCV positive as were 3/58 (5%) of the hemodialysis patients. Over liver disease occurred in 22/252 (8.7%) transplant recipients and none in the hemodialysis group. Thirty-six percent (8/22) of transplant recipients with overt liver disease were HCV positive. No HCV-positive patients died of liver failure. Of six biopsies in the HCV-positive transplant group, two had histological evidence of CAH. CAH was seen in six of eight biopsies in the HCV-negative transplants and two of these latter patients progressed to cirrhosis. No hemodialysis patients had clinical or histological evidence of chronic liver disease. Two HCV-negative transplant patients died of liver failure, while no deaths related to liver disease occurred in hemodialysis patients regardless of HCV status. We conclude that hepatitis C may cause chronic hepatitis in renal transplant patients. However, chronic liver disease in HCV-positive renal transplant recipients appears to be a clinically and histologically benign entity. HCV-positive potential renal allograft recipients with normal liver biochemistry should not be excluded from renal transplantation.

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References

  1. Anuras S, Piros J, Corry R, Boney WW, Forker EL, Colville DS: Liver disease in renal transplant recipients. Arch Intern Med 137:42–48, 1977

    PubMed  Google Scholar 

  2. Mozes MF, Ascher NL, Najarian JS: Jaundice after renal allo-transplantation. Ann Surg 188:783–790, 1978

    PubMed  Google Scholar 

  3. Ware AJ, Luby JP, Eigenbrodt EH, Long DL, Hull AR: Spectrum of liver disease in renal transplant recipients. Gastroenterology 68:755–764, 1975

    PubMed  Google Scholar 

  4. Boyce NW, Holdsworth SR, Hooke D, Thomson NM, Atkins RC: Non-hepatitis-associated liver disease in a renal transplant population. Am J Kidney Dis 11:307–312, 1988

    PubMed  Google Scholar 

  5. Parfrey PS, Farge D, Guttmann RD, Dandavino R, Kenick S: Chronic hepatitis in end stage renal disease. Comparison of HBsAg negative and HBsAg positive patients. Kidney Int 28:959–967, 1985

    PubMed  Google Scholar 

  6. Pien FD, Smith TF, Anderson CF, Webel ML, Taswell HF: Herpes virus in renal transplant patients. Transplantation 16:489–495, 1973

    PubMed  Google Scholar 

  7. Fine RN, Grushkin CM, Malekzadehm M, Wright HT: Cytomegalovirus syndrome following renal transplantation. Arch Surg 105:564–570, 1972

    PubMed  Google Scholar 

  8. Chang RS, Lewis JP, Reynolds RD, Neuman J, Sullivan MJ: Oropharyngeal excretion of Epstein-Barr virus by patients with lymphoproliferative disorder and recipients of renal homograft. Ann Intern Med 88:34–40, 1978

    PubMed  Google Scholar 

  9. Sparberg M, Simon M, Del-Greco F: Intrahepatic cholestasis due to azathioprine. Gastroenterology 57:439–441, 1969

    PubMed  Google Scholar 

  10. Shorey J, Schenker S, Sukilon Combes B: Hepatoxicity of mercaptopurine. Arch Intern Med 122:54–58, 1968

    PubMed  Google Scholar 

  11. Laquaglia MP, Tolkoff-Rubin NE, Rubin R, Dienstag JL, Cosimi AB, Herrin JT, Kelly M: Impact of hepatitis on renal transplantation. Transplantation 32:504–507, 1981

    PubMed  Google Scholar 

  12. Briggs WA, Lazarus TM, Birtch AG, Hampers CL, Hager EB, Merrill JP: Hepatitis affecting hemodialysis and transplant recipients: Its considerations and consequences. Arch Intern Med 132:21–28, 1973

    PubMed  Google Scholar 

  13. Parfrey PS, Forbes RDC, Hutchinson TA, Guttman RD: The prevalence and progression of liver disease in renal transplant recipients. A histological study. Transplant Proc 16:1103–1105, 1984

    Google Scholar 

  14. Pereira BJ, Milford EL, Kirkman RL, Quan S, Sayre KR, Johnson PJ, Wilbur JC, Levy AS: Prevalence of hepatitis C virus rna in organ donors positive for hepatitis C antibody and in recipients of their organs. N Engl J Med 327:910–915, 1992

    PubMed  Google Scholar 

  15. Roth D, Fernandez JA, Miller J, Burke GW, Esquenazi V: Detection of antibody to hepatitis C virus in renal transplant recipients. Transplantation 51:396–400, 1991

    PubMed  Google Scholar 

  16. Huang C, Liaw YF, Huang Y: The clinical outcome of hepatitis C virus antibody positive renal allograft recipients. Transplantation 53:763–765, 1992

    PubMed  Google Scholar 

  17. Stempel CA, Lake J, Kuo G, Vincenti F: Hepatitis C—its prevalence in end-stage renal failure patients and clinical course after kidney transplantation. Transplantation 55:273–276, 1993

    PubMed  Google Scholar 

  18. Marcen R, Pascual J, Ortuno J, Fernandez-Munoz R, Teruel JL, Lian OF, Celma ML: Hepatitis C virus infection in kidney transplant patients. Transplant Proc 24:87–88, 1992

    PubMed  Google Scholar 

  19. Ponz E, Campistol JM, Andreu J, Bruguera M, Barrera JM, Gil C, Pinto JB: Hepatitis C virus infection among kidney transplant recipients. Kidney Int 40:748–751, 1992

    Google Scholar 

  20. Lam KC, Trepo C, Wu PC: Deleterious effect of prednisolone in HBsAg positive chronic active hepatitis. N Engl J Med 304:380–386, 1981

    PubMed  Google Scholar 

  21. Hoofnagle JH, Dusheiko GM, Schafer DF, Jones EA, Micetich KC, Young RC, Costa J: Reactivation of chronic hepatitis B virus infection by cancer chemotherapy. Ann Intern Med 96:447–449, 1982

    PubMed  Google Scholar 

  22. Dusheiko G, Song E, Bowyer S, Whitcutt M, Mair G, Meyers A, Kew MC: Natural history of hepatitis B virus infection in renal transplant recipients—a fifteen year follow-up. Hepatology 3:330–336, 1983

    PubMed  Google Scholar 

  23. Weiner AJ, Kuo G, Bradley DW, Choo QL, Bonino F, Saracco G, Lee L, Rosenblat J, Houghton M: Detection of hepatitis C viral sequences in non-A, non-B hepatitis. Lancet 335:1–3, 1990

    PubMed  Google Scholar 

  24. Degos F, Degott C, Bedrossian J, Camiliert JP, Barbanel C, Dubost A, Rueff B, Benhamou JP, Kreis H: Is renal transplantation involved in post transplant liver disease. Transplantation 29:100–102, 1980

    PubMed  Google Scholar 

  25. Wolf PL, William D, Coplom H, Coulson AS: Low aspartate transaminase activity in serum of patients undergoing chronic hemodialysis. Clin Chem 18:567–568, 1972

    PubMed  Google Scholar 

  26. Pereira BJG, Milford EL, Kirkman RL, Sayre KR, Johnson PJ, Wilber JC, Quan S, Levey AS: Prevalence of HCV RNA in hepatitis C antibody positive cadaver organ donors and recipients of organs from these donors. Transplantation 1994 (in press)

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Authors and Affiliations

  1. From the Department of Medicine and Department of Surgery, University of Illinois at Chicago, USA

    S. Kazi MD, S. Prasad MD,  R. Pollak MD, T. Holzer PhD, C. Heynen, A. J. Fabrega MD, D. Pitrak MD & T. J. Layden MD

  2. Immunodiagnostics Division, Abbott Laboratories, USA

    S. Kazi MD, S. Prasad MD,  R. Pollak MD, T. Holzer PhD, C. Heynen, A. J. Fabrega MD, D. Pitrak MD & T. J. Layden MD

Authors
  1. S. Kazi MD
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  2. S. Prasad MD
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  3. R. Pollak MD
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  4. T. Holzer PhD
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  5. C. Heynen
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  6. A. J. Fabrega MD
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  7. D. Pitrak MD
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  8. T. J. Layden MD
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Additional information

Presented in abstract form (Gastroenterology 102:A830, 1992) at the American Gastroenterological Association, April 1992.

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Kazi, S., Prasad, S., Pollak, R. et al. Hepatitis C infection in potential recipients with normal liver biochemistry does not preclude renal transplantation. Digest Dis Sci 39, 961–964 (1994). https://doi.org/10.1007/BF02087544

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  • DOI: https://doi.org/10.1007/BF02087544

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