High pretransplant HBV level predicts HBV reactivation after kidney transplantation in HBV infected recipients.
10.4174/astr.2014.86.5.256
- Author:
Jong Man KIM
1
;
Hyojun PARK
;
Hye Ryoun JANG
;
Jae Berm PARK
;
Choon Hyuck David KWON
;
Wooseong HUH
;
Joon Hyeok LEE
;
Sung Joo KIM
;
Jae Won JOH
Author Information
1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kmhyj111@skku.edu
- Publication Type:Original Article
- Keywords:
Kidney transplantation;
Hepatitis B virus;
YMDD mutation;
HBV reactivation
- MeSH:
Allografts;
Antiviral Agents;
Carcinoma, Hepatocellular;
DNA;
Follow-Up Studies;
Graft Survival;
Hepatitis B virus;
Humans;
Kidney;
Kidney Transplantation*;
Liver Diseases;
Medical Records;
Mortality;
Multivariate Analysis;
Retrospective Studies;
Risk Factors;
Transplantation;
Transplants
- From:Annals of Surgical Treatment and Research
2014;86(5):256-263
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: HBsAg-positive kidney recipients are at increased risk for mortality and graft failure. The aims of this study were to identify the outcomes of HBsAg-positive recipients who received preemptive antiviral agents after successful kidney transplantation and to analyze risk factors for HBV reactivation. METHODS: We retrospectively reviewed the medical records of 944 patients performed kidney transplantation between 1999 and 2010. RESULTS: HBsAg-negative recipients were 902 patients and HBsAg-positive recipients, 42. Among HBsAg-positive recipients, HBV reactivation was detected in 7 patients and well controlled by switch or combination therapy. Graft failure developed in only one patient due to chronic rejection regardless of HBV reactivation but no deaths occurred. All patients were alive at the end of follow-up and none developed end-stage liver disease or hepatocellular carcinoma. There was statistically significant difference in graft survival between HBsAg-positive recipients and HBsAg-negative. Multivariate analysis identified increased HBV DNA levels (>5 x 10(4) IU/mL) in the HBsAg-positive kidney transplant recipients as a risk factor for HBV reactivation (P = 0.007). CONCLUSION: Effective viral suppression with antiviral agents in HBsAg-positive renal transplant recipients improves patient outcome and allograft survival. Antiviral therapy may be especially beneficial in patients with high HBV DNA levels prior to transplantation.
