A prospective study of hepatitis C virus infection in renal allograft recipients

David Roth, Keith Zucker, Robert Cirocco, George W Burke, Gaetano Ciancio, Violet Esquenazi, Sidney J. Swanson, Joshua Miller

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

Hepatitis C virus (HCV) is the predominant cause of posttransplant non-A, non-B hepatitis among renal allograft recipients. Prior studies evaluating the impact of HCV in kidney transplantation have been retrospective in design and based largely on changes in serum transaminases. We studied a group of HCV-infected end-stage renal disease patients prospectively with pretransplant liver biopsies and close virologic and biochemical follow-up posttransplant. Fourteen patients have been followed a mean of 11.6±5.6 months posttransplant (range, 5-21 months). Six had changes of chronic hepatitis on pretransplant liver biopsy while 8 showed only mild histologic abnormalities. Circulating vital titers increased several-fold over baseline levels during posttransplant follow-up. Viral replication was particularly enhanced immediately following a course of antilymphocyte therapy. Although all patients showed a 2-3-fold increase in alanine aminotransferase (ALT) following transplantation, there were no associations noted between pretransplant liver histology, the use of FK506 and/or cyclosporine-based immunosuppression, and the magnitude of ALT change posttransplant. The only clinical outcome found to differ significantly was a higher incidence of cytomegalovirus infection among patients with chronic hepatitis. All patients are alive with functioning grafts. There have been no episodes of fulminant or subfulminant liver failure. We conclude that HCV-infected patients can be safely transplanted with excellent short-term follow-up. Continued monitoring with sequential liver biopsies will be needed to define the long-term course of HCV infection in an immunosuppressed population.

Original languageEnglish
Pages (from-to)886-889
Number of pages4
JournalTransplantation
Volume61
Issue number6
DOIs
StatePublished - Mar 27 1996

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Virus Diseases
Hepacivirus
Allografts
Prospective Studies
Kidney
Liver
Chronic Hepatitis
Alanine Transaminase
Biopsy
Liver Failure
Cytomegalovirus Infections
Tacrolimus
Transaminases
Kidney Transplantation
Immunosuppression
Cyclosporine
Hepatitis
Chronic Kidney Failure
Histology
Transplantation

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

A prospective study of hepatitis C virus infection in renal allograft recipients. / Roth, David; Zucker, Keith; Cirocco, Robert; Burke, George W; Ciancio, Gaetano; Esquenazi, Violet; Swanson, Sidney J.; Miller, Joshua.

In: Transplantation, Vol. 61, No. 6, 27.03.1996, p. 886-889.

Research output: Contribution to journalArticle

Roth, David ; Zucker, Keith ; Cirocco, Robert ; Burke, George W ; Ciancio, Gaetano ; Esquenazi, Violet ; Swanson, Sidney J. ; Miller, Joshua. / A prospective study of hepatitis C virus infection in renal allograft recipients. In: Transplantation. 1996 ; Vol. 61, No. 6. pp. 886-889.
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