Hepatitis C and renal transplantation

Morales, José; Aguado, José María

doi:10.1097/mot.0b013e32835a2bac

Cited by 24 publications

(19 citation statements)

References 36 publications

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“…A particular feature of this series is the high number of patients with HCV infection, mainly located in the group of transplant failure, showing a significant positive association with the lower graft survival (OR 12.5, 95% CI 2.50–63.34), in the same manner as that described in non-SLE patients [37, 38]. Recent evidence documents that the concomitant HCV infection in patients with lupus nephritis is associated with worse renal outcome, higher rate of progression to ESRD, and reduced patient survival [39].…”

Section: Discussionsupporting

confidence: 63%

Renal Transplantation in Systemic Lupus Erythematosus: Outcome and Prognostic Factors in 50 Cases from a Single Centre

Cairoli

Sánchez-Marcos

Espinosa

et al. 2014

BioMed Research International

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Background. End-stage renal disease (ESRD) is an important cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Objectives. To analyze the outcome and prognostic factors of renal transplantation in patients with ESRD due to SLE from January 1986 to December 2013 in a single center. Results. Fifty renal transplantations were performed in 40 SLE patients (32 female (80%), mean age at transplantation 36 ± 10.4 years). The most frequent lupus nephropathy was type IV (72.2%). Graft failure occurred in a total of 15 (30%) transplantations and the causes of graft failure were chronic allograft nephropathy (n = 12), acute rejection (n = 2), and chronic humoral rejection (1). The death-censored graft survival rates were 93.9% at 1 year, 81.5% at 5 years, and 67.6% at the end of study. The presence of deceased donor allograft (P = 0.007) and positive anti-HCV antibodies (P = 0.001) negatively influence the survival of the renal transplant. The patient survival rate was 91.4% at the end of the study. Recurrence of lupus nephritis in renal allograft was observed in one patient. Conclusion. Renal transplantation is a good alternative for renal replacement therapy in patients with SLE. In our cohort, the presence of anti-HCV antibodies and the type of donor source were related to the development of graft failure.

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Section: Discussionsupporting

confidence: 63%

Renal Transplantation in Systemic Lupus Erythematosus: Outcome and Prognostic Factors in 50 Cases from a Single Centre

Cairoli

Sánchez-Marcos

Espinosa

et al. 2014

BioMed Research International

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“…Various studies have revealed that, overall patient and graft survival are significantly shortened. Mortality resulting from liver disease as well as the risk of developing hepatocellular carcinoma are increased in HCV-positive kidney transplant recipients 33,34. Good survival rates have been obtained in these patients, especially if they have minimal or well-controlled liver disease 35.…”

Section: Hcv Infection In Kidney Transplant Recipientsmentioning

confidence: 99%

Management of chronic hepatitis C virus infection in patients with end-stage renal disease: a review

Valadez

Juárez

Pedrero

et al. 2015

TCRM

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Infection with hepatitis C virus (HCV) is highly prevalent in chronic kidney disease (CKD) patients, mainly in those on hemodialysis (HD). The seroprevalence of HCV in developing countries ranges between 7% and 40%. Risk factors for this infection in the CKD population include the number of blood transfusions, duration of end-stage renal disease (ESRD), and prevalence of HCV in HD. Chronic HCV infection in patients with ESRD is associated with an increase in morbidity and mortality in the pre and post kidney transplant periods. The increase in mortality is directly associated with liver complications and an elevated cardiovascular risk in HCV-infected patients on hemodialysis. Antiviral treatment may improve the prognosis of patients with HCV, and standard interferon remains the cornerstone of treatment. Treatment of HCV in patients with CKD is complex, but achieving a sustained viral response may decrease the frequency of complications after transplantation. It appears that HCV-infected patients who remain on maintenance dialysis are at increased risk of death compared with HCV patients undergoing renal transplantation.

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“…As noted previously, KT is associated with better long-term survival for ESRD patients, even those diagnosed with HCV infection. In other words, anti-HCV positivity must not preclude HD patients from KT [48] .…”

Section: Hcv Infection After Ktmentioning

confidence: 99%

Hepatitis C infection in hemodialysis patients: A review

Etık

Öcal

Boyacioglu

2015

WJH

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Hepatitis C virus (HCV)-related liver disease is a significant cause of morbidity and mortality in patients with end-stage renal disease (ESRD) who is treated with dialysis or kidney transplantation (KT). The survival rate for HCV-infected renal transplant recipients is better than that for HCV-infected hemodialysis patients on transplant waiting lists. Early diagnosis and treatment HCV infection prior to KT prevents complications posttransplantation and reduces mortality. In addition to screening for anti-HCV antibodies and detecting HCV RNA, percutaneous liver biopsy is particularly valuable for assessing the stage of liver damage in HCV-infected patients, because the stage of fibrosis is important determining optimal treatment for HCV. Studies have been demonstrated that with conventional interferon (IFN) monotherapy or pegylated IFN monotherapy are similar efficacy and safety in HCV-infected hemodialysis patients. Sustained viral responses (SVRs) with these monotherapies have ranged approximately 30% to 40%. Limited reports support the use of IFN and ribavirin combination therapy as antiviral treatment for ESRD patients or patients on hemodialysis. Ribavirin can be started at low dose and careful monitoring for side effects. Patients that show SVR after treatment are strong candidates for KT. It is also generally accepted that ESRD patients with decompensated cirrhosis and portal hypertension should be referred to the liver transplant team for consideration of combined liver-KT.

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Hepatitis C and renal transplantation

Abstract: Renal transplantation is the therapy of choice for dialysis patients with HCV infection. To improve the results, a careful follow-up in the outpatient clinic for early detection of HCV-related complications is mandatory.

Cited by 24 publications

References 36 publications

Renal Transplantation in Systemic Lupus Erythematosus: Outcome and Prognostic Factors in 50 Cases from a Single Centre

Renal Transplantation in Systemic Lupus Erythematosus: Outcome and Prognostic Factors in 50 Cases from a Single Centre

Management of chronic hepatitis C virus infection in patients with end-stage renal disease: a review

Hepatitis C infection in hemodialysis patients: A review

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