Kidney transplantation in the patient with hepatitis C virus infection

Jose M. Morales, Roy Bloom, David Roth

Research output: Chapter in Book/Report/Conference proceedingChapter

23 Citations (Scopus)

Abstract

Liver disease is an important comorbidity following kidney transplantation, and hepatitis C virus (HCV) infection has been demonstrated to be the leading cause of this complication. Anti-HCV-positive kidney transplant recipients have a higher risk for developing proteinuria, chronic rejection, infections, glomerulonephritis and new-onset diabetes after transplantation (NODAT). Together with progressive liver disease in some patients, these complications all contribute to inferior patient and graft survival rates observed in anti-HCV-positive patients when compared to their uninfected counterparts. The increased mortality in the anti-HCV-positive cohort is largely as a result of a higher incidence of cardiovascular disease, liver disease and infections. HCV can also contribute to the development of some extrahepatic neoplasias, such as posttransplant lymphoproliferative disease. HCV infection is also an independent risk factor for graft loss, likely contributed to by the development of NODAT, chronic rejection/transplant glomerulopathy and HCVrelated glomerulonephritis. Despite the increased comorbidities associated with kidney transplant in the HCV-infected patient, transplantation offers the best long-term outcomes for the end-stage renal disease patient with HCV infection. Finally, several interventions designed to minimize the potentially adverse consequences of HCV infection should be considered in the posttransplant setting. Adjustment of immunosuppression and careful follow-up in the outpatient clinic for early detection of proteinuria, renal insufficiency, infection, NODAT, neoplasia or worsening of liver disease are important components of the posttransplant care of the patient with HCV infection.

Original languageEnglish (US)
Title of host publicationHepatitis C in Renal Disease, Hemodialysis and Transplantation
PublisherS. Karger AG
Pages77-86
Number of pages10
Volume176
ISBN (Print)9783805598217, 9783805598200
DOIs
StatePublished - Jan 23 2012

Fingerprint

Virus Diseases
Hepacivirus
Kidney Transplantation
Liver Diseases
Transplantation
Glomerulonephritis
Transplants
Proteinuria
Comorbidity
Infection
Kidney
Graft Rejection
Graft Survival
Ambulatory Care Facilities
Immunosuppression
Chronic Kidney Failure
Renal Insufficiency
Neoplasms
Patient Care
Cardiovascular Diseases

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Morales, J. M., Bloom, R., & Roth, D. (2012). Kidney transplantation in the patient with hepatitis C virus infection. In Hepatitis C in Renal Disease, Hemodialysis and Transplantation (Vol. 176, pp. 77-86). S. Karger AG. https://doi.org/10.1159/000332385

Kidney transplantation in the patient with hepatitis C virus infection. / Morales, Jose M.; Bloom, Roy; Roth, David.

Hepatitis C in Renal Disease, Hemodialysis and Transplantation. Vol. 176 S. Karger AG, 2012. p. 77-86.

Research output: Chapter in Book/Report/Conference proceedingChapter

Morales, JM, Bloom, R & Roth, D 2012, Kidney transplantation in the patient with hepatitis C virus infection. in Hepatitis C in Renal Disease, Hemodialysis and Transplantation. vol. 176, S. Karger AG, pp. 77-86. https://doi.org/10.1159/000332385
Morales JM, Bloom R, Roth D. Kidney transplantation in the patient with hepatitis C virus infection. In Hepatitis C in Renal Disease, Hemodialysis and Transplantation. Vol. 176. S. Karger AG. 2012. p. 77-86 https://doi.org/10.1159/000332385
Morales, Jose M. ; Bloom, Roy ; Roth, David. / Kidney transplantation in the patient with hepatitis C virus infection. Hepatitis C in Renal Disease, Hemodialysis and Transplantation. Vol. 176 S. Karger AG, 2012. pp. 77-86
@inbook{80444b09b4674d04bf1ef3dd6fccf2b1,
title = "Kidney transplantation in the patient with hepatitis C virus infection",
abstract = "Liver disease is an important comorbidity following kidney transplantation, and hepatitis C virus (HCV) infection has been demonstrated to be the leading cause of this complication. Anti-HCV-positive kidney transplant recipients have a higher risk for developing proteinuria, chronic rejection, infections, glomerulonephritis and new-onset diabetes after transplantation (NODAT). Together with progressive liver disease in some patients, these complications all contribute to inferior patient and graft survival rates observed in anti-HCV-positive patients when compared to their uninfected counterparts. The increased mortality in the anti-HCV-positive cohort is largely as a result of a higher incidence of cardiovascular disease, liver disease and infections. HCV can also contribute to the development of some extrahepatic neoplasias, such as posttransplant lymphoproliferative disease. HCV infection is also an independent risk factor for graft loss, likely contributed to by the development of NODAT, chronic rejection/transplant glomerulopathy and HCVrelated glomerulonephritis. Despite the increased comorbidities associated with kidney transplant in the HCV-infected patient, transplantation offers the best long-term outcomes for the end-stage renal disease patient with HCV infection. Finally, several interventions designed to minimize the potentially adverse consequences of HCV infection should be considered in the posttransplant setting. Adjustment of immunosuppression and careful follow-up in the outpatient clinic for early detection of proteinuria, renal insufficiency, infection, NODAT, neoplasia or worsening of liver disease are important components of the posttransplant care of the patient with HCV infection.",
author = "Morales, {Jose M.} and Roy Bloom and David Roth",
year = "2012",
month = "1",
day = "23",
doi = "10.1159/000332385",
language = "English (US)",
isbn = "9783805598217",
volume = "176",
pages = "77--86",
booktitle = "Hepatitis C in Renal Disease, Hemodialysis and Transplantation",
publisher = "S. Karger AG",

}

TY - CHAP

T1 - Kidney transplantation in the patient with hepatitis C virus infection

AU - Morales, Jose M.

AU - Bloom, Roy

AU - Roth, David

PY - 2012/1/23

Y1 - 2012/1/23

N2 - Liver disease is an important comorbidity following kidney transplantation, and hepatitis C virus (HCV) infection has been demonstrated to be the leading cause of this complication. Anti-HCV-positive kidney transplant recipients have a higher risk for developing proteinuria, chronic rejection, infections, glomerulonephritis and new-onset diabetes after transplantation (NODAT). Together with progressive liver disease in some patients, these complications all contribute to inferior patient and graft survival rates observed in anti-HCV-positive patients when compared to their uninfected counterparts. The increased mortality in the anti-HCV-positive cohort is largely as a result of a higher incidence of cardiovascular disease, liver disease and infections. HCV can also contribute to the development of some extrahepatic neoplasias, such as posttransplant lymphoproliferative disease. HCV infection is also an independent risk factor for graft loss, likely contributed to by the development of NODAT, chronic rejection/transplant glomerulopathy and HCVrelated glomerulonephritis. Despite the increased comorbidities associated with kidney transplant in the HCV-infected patient, transplantation offers the best long-term outcomes for the end-stage renal disease patient with HCV infection. Finally, several interventions designed to minimize the potentially adverse consequences of HCV infection should be considered in the posttransplant setting. Adjustment of immunosuppression and careful follow-up in the outpatient clinic for early detection of proteinuria, renal insufficiency, infection, NODAT, neoplasia or worsening of liver disease are important components of the posttransplant care of the patient with HCV infection.

AB - Liver disease is an important comorbidity following kidney transplantation, and hepatitis C virus (HCV) infection has been demonstrated to be the leading cause of this complication. Anti-HCV-positive kidney transplant recipients have a higher risk for developing proteinuria, chronic rejection, infections, glomerulonephritis and new-onset diabetes after transplantation (NODAT). Together with progressive liver disease in some patients, these complications all contribute to inferior patient and graft survival rates observed in anti-HCV-positive patients when compared to their uninfected counterparts. The increased mortality in the anti-HCV-positive cohort is largely as a result of a higher incidence of cardiovascular disease, liver disease and infections. HCV can also contribute to the development of some extrahepatic neoplasias, such as posttransplant lymphoproliferative disease. HCV infection is also an independent risk factor for graft loss, likely contributed to by the development of NODAT, chronic rejection/transplant glomerulopathy and HCVrelated glomerulonephritis. Despite the increased comorbidities associated with kidney transplant in the HCV-infected patient, transplantation offers the best long-term outcomes for the end-stage renal disease patient with HCV infection. Finally, several interventions designed to minimize the potentially adverse consequences of HCV infection should be considered in the posttransplant setting. Adjustment of immunosuppression and careful follow-up in the outpatient clinic for early detection of proteinuria, renal insufficiency, infection, NODAT, neoplasia or worsening of liver disease are important components of the posttransplant care of the patient with HCV infection.

UR - http://www.scopus.com/inward/record.url?scp=84926110420&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84926110420&partnerID=8YFLogxK

U2 - 10.1159/000332385

DO - 10.1159/000332385

M3 - Chapter

SN - 9783805598217

SN - 9783805598200

VL - 176

SP - 77

EP - 86

BT - Hepatitis C in Renal Disease, Hemodialysis and Transplantation

PB - S. Karger AG

ER -