Abstract
Kidney transplant recipients have a high incidence of chronic liver disease (CHD), which sometimes results in death. The causes of death in 17 (34.7%) of 49 kidney transplant recipients with a functioning graft were highly correlated with CHD, including hepatic failure in 10, hepatic failure with serious infection in 2, hepatic failure with myocardial infarction in one and hepatoma in 4. While the incidence of hepatitis B virus infection has been declining, the incidence of CHD has not decreased proportionately.
Hepatitis C virus (HCV) infection seems to be responsible for this. To determine the prevalence of antibodies to HCV (anti-HCV) using a second generation ELISA test, a retrospective study was performed on 198 kidney transplant recipients with a functioning graft. Three of the 198 recipients were positive for both anti-HCV and HBs antigen, 7 were HBs antigen-positive and anti-HCV-negative, 34 were positive for anti-HCV alone and 154 recipients were negative for both. A long-standing serum transaminase (ALT) abnormality occurred in all recipients positive for both anti-HCV and HBs antigen, and in 17 (50%) of 34 anti-HCV-positive recipients. The group of anti-HCV-positive recipients had been on hemodialysis significantly longer and had received a significantly higher number of blood transfusions prior to transplantation than the anti-HCV-negative recipients. There were no significant differences in age, sex or a number of blood transfusions after receiving the kidney graft. When the anti-HCV-positive rates in groups of recipients categorized according to year of institution of hemodialysis therapy were compared, no positive cases were found in the groups of recipients placed on hemodialysis therapy
