Hepatitis B Virus, Hepatitis C Virus, and Kidney Transplant Acute Rejection and Survival

Grenha, V.; Parada, B.; Ferreira, Cristina; Figueiredo, Arnaldo; Macário, Fernando; Alves, Rui; Coelho, Hugo; Sepulveda, L; Freire, Maria José; Retroz, E.; Mota, Alexandre

doi:10.1016/j.transproceed.2015.04.004

Cited by 9 publications

(12 citation statements)

References 12 publications

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“…Eighteen of them were excluded from the full-length review as they did not report the outcome of interest while six articles were excluded because they were descriptive studies without comparative analysis. Thus, the final analysis included 10 cohort studies[ 18 , 21 , 31 , 36 , 52 - 57 ] with 87623 kidney transplant patients. The literature retrieval, review, and selection process are demonstrated in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Of 10 studies[ 18 , 21 , 31 , 36 , 52 - 57 ], 3 studies[ 18 , 21 , 54 ] provided data on prophylactic antiviral treatment for HBV. When meta-analysis was limited only to studies with HBsAg-positive recipients (> 50%) treated with prophylactic antiviral treatment for HBV, the pooled OR of mortality was 3.85 (95%CI: 0.91-16.23, I 2 = 50%).…”

Section: Resultsmentioning

confidence: 99%

“…Long-term graft survival, however, has remained relatively lagged behind and has now become one of the main problems in kidney transplantation[ 7 - 9 ]. Although HBV is preventable disease by HBV vaccine, HBV infection remains a challenge issue in patients with end-stage renal disease on dialysis, affecting from 1.3% up to 14.6% of chronic dialysis patients [hepatitis B surface antigen (HBsAg) –positive] depending on geographical regions[ 10 - 12 ], and, consequently leading to chronic HBV infection kidney transplant patients[ 13 - 31 ]. Among renal transplant patients with HBV (HBsAg positive), there have been reported cases of HBV reactivation[ 32 ], massive liver necrosis due to fulminant hepatitis, and severe cholestatic hepatitis after kidney transplantation[ 10 , 16 , 33 - 36 ].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of kidney transplantation in patients with hepatitis B virus infection: A systematic review and meta-analysis

Kaewput

Sharma

Wijarnpreecha³

et al. 2018

WJH

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AIMTo assess outcomes of kidney transplantation including patient and allograft outcomes in recipients with hepatitis B virus (HBV) infection, and the trends of patient’s outcomes overtime.METHODSA literature search was conducted using MEDLINE, EMBASE and Cochrane Database from inception through October 2017. Studies that reported odds ratios (OR) of mortality or renal allograft failure after kidney transplantation in patients with HBV [defined as hepatitis B surface antigen (HBsAg) positive] were included. The comparison group consisted of HBsAg-negative kidney transplant recipients. Effect estimates from the individual study were extracted and combined using random-effect, generic inverse variance method of DerSimonian and Laird. The protocol for this meta-analysis is registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42017080657).RESULTSTen observational studies with a total of 87623 kidney transplant patients were enrolled. Compared to HBsAg-negative recipients, HBsAg-positive status was significantly associated with increased risk of mortality after kidney transplantation (pooled OR = 2.48; 95%CI: 1.61-3.83). Meta-regression showed significant negative correlations between mortality risk after kidney transplantation in HBsAg-positive recipients and year of study (slopes = -0.062, P = 0.001). HBsAg-positive status was also associated with increased risk of renal allograft failure with pooled OR of 1.46 (95%CI: 1.08-1.96). There was also a significant negative correlation between year of study and risk of allograft failure (slopes = -0.018, P = 0.002). These associations existed in overall analysis as well as in limited cohort of hepatitis C virus-negative patients. We found no publication bias as assessed by the funnel plots and Egger’s regression asymmetry test with P = 0.18 and 0.13 for the risks of mortality and allograft failure after kidney transplantation in HBsAg-positive recipients, respectively.CONCLUSIONAmong kidney transplant patients, there are significant associations between HBsAg-positive status and poor outcomes including mortality and allograft failure. However, there are potential improvements in patient and graft survivals in HBsAg-positive recipients overtime.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of kidney transplantation in patients with hepatitis B virus infection: A systematic review and meta-analysis

Kaewput

Sharma

Wijarnpreecha³

et al. 2018

WJH

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“…Recent studies reveal a significant association between hepatitis B virus infection and poor patient and graft survival in kidney transplant recipients. 42,43 A significant association between hepatitis C virus infection and decreased graft survival and increased rate of acute rejection has also been reported. 43…”

Section: Discussionmentioning

confidence: 97%

Low-dose Rituximab and Thymoglobulin Induction With Steroid-free Maintenance Immunosuppression and Protocol Biopsies Improves Long-term Patient and Graft Survival After Kidney Transplantation: Survival and Safety Outcomes in More Than 1100 Patients From a Single Center

Pathak

Madhavan

Narayanasamy

et al. 2019

Transplantation Direct

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Background. Steroid-free maintenance immunosuppression after kidney transplantation provides acceptable patient and graft survival and minimizes steroid-associated side effects among recipients with a low immunological risk. However, the long-term outcomes of such protocols, incorporating low-dose rituximab and thymoglobulin induction along with protocol biopsies, in non-European populations remains underreported. Methods. We retrospectively analyzed 1142 consecutive kidney transplantations conducted at our center from July 2005 to October 2017. Immunosuppression protocol included induction with thymoglobulin and low-dose preoperative rituximab. Maintenance immunosuppression consisted of tacrolimus and mycophenolate mofetil; prednisolone was discontinued on postoperative day 5. Protocol biopsies were carried out at 3 months and at 1, 5, and 10 years after transplantation—in addition to the indicated biopsies. The 12-year patient and graft survival and posttransplantation complications were studied. Results. The analysis of outcomes was conducted for 1111 transplant recipients. Patients (70.59%) remained steroid-free at 12 years after transplantation. The patient survival rates at 1, 5, and 12 years were 97.7%, 94.8%, and 92.4%, respectively. The corresponding graft survival rates were 97.2%, 90.9%, and 86.1%, respectively. Biopsy-proven acute rejection occurred in 12.7% of recipients, including 3.5% subclinical rejections. The cumulative incidence of graft loss was 6.56% at 12.3 years. The overall incidence of death was 5.3%. Conclusions. Steroid-free maintenance immunosuppression was associated with excellent long-term patient and graft survival rates and reduced incidence of prednisolone-related side effects, despite acceptable rejection rates. Low-dose rituximab with thymoglobulin induction with immediate steroid withdrawal and surveillance biopsies resulted in excellent long-term outcomes in our single-center experience.

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“…Moreover, the amount of bFGF was determined from a calibration curve based on known bFGF concentrations. Finally, encapsulation efficiency (EE%) and loading content (LC) were derived using the following equations (Grenha et al, 2005):…”

Section: Characterization Of Bfgf-loaded Cs-f Nanoparticlesmentioning

confidence: 99%

Effect of basic fibroblast growth factor released from chitosan-fucoidan nanoparticles on neurite extension

Huang

Yang

2013

J Tissue Eng Regen Med

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Exogenous growth factors are an integral part of an effective nerve tissue-engineering strategy. Basic fibroblast growth factor (bFGF) has a marked positive effect on angiogenesis and neuronal cell survival. However, bFGF is limited by its short half-life and easy degradation by enzymes. Therefore, in this study novel biodegradable chitosan-fucoidan nanoparticles (CS-F NPs) were designed to carry bFGFs and maintain their activities. The experimental results indicated that chitosan and fucoidan form stable nanoparticles approximately 200 nm in size via electrostatic interactions. Additionally, the effectiveness of nanoparticles is related to their chitosan:fucoidan weight ratio. The CS-F NPs control the release of bFGFs and protect bFGF from deactivation by heat and enzymes. In vitro cell studies demonstrate that CS-F NPs have no cytotoxicity to PC12 cells, as the concentration of NPs is 125 ng/ml. Moreover, the CS-F NPs significantly decrease the amount of bFGF needed for neurite extension. The cumulative release of bFGF from CS-F NPs at 24 h is 0.168 ng/ml, markedly lower than that in solution (4.2 ng/ml). Importantly, CS-F NPs are potential carriers for delivering bFGFs for nerve tissue engineering. Copyright © 2013 John Wiley & Sons, Ltd.

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Hepatitis B Virus, Hepatitis C Virus, and Kidney Transplant Acute Rejection and Survival

Cited by 9 publications

References 12 publications

Outcomes of kidney transplantation in patients with hepatitis B virus infection: A systematic review and meta-analysis

Outcomes of kidney transplantation in patients with hepatitis B virus infection: A systematic review and meta-analysis

Low-dose Rituximab and Thymoglobulin Induction With Steroid-free Maintenance Immunosuppression and Protocol Biopsies Improves Long-term Patient and Graft Survival After Kidney Transplantation: Survival and Safety Outcomes in More Than 1100 Patients From a Single Center

Effect of basic fibroblast growth factor released from chitosan-fucoidan nanoparticles on neurite extension

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