Impact of hepatitis C on renal transplantation : a long-term study

Viral hepatitis, especially "C" type (HCV), is an important cause of morbidity and mortality among recipients of renal transplants. In a retrospective long-term study, we reviewed 399 renal transplant patients (133F, 266M) who received 415 kidneys during the past eight-years. We evaluated their HCV infection and liver status. Stored sera (frozen at 80 C) as well as fresh sera collected at the time of transplant and/or at the last observation were used. The donors were cadavers in 386 and living related in 29 renal transplants. The mean follow-up period was 74 months (range 24-124 months). At the time of transplantation 105 recipients (26%) were HCV positive. A the last follow-up 105 (26%) recipients remained positive, 12 (2.8%) seroconverted from negative to positive due to graft and/or blood transfusion and 277 remained negative. Liver biopsy was obtained from 71 to 117 (60.6%) HCV +ve patients. Liver biopsy showed normal histology in 57 (80%) patients, chronic active hepatitis in 42 (59%) patients according to scoring of Knodle's classification. Recurrence of glomerulonephritis in renal allografts occurred in 21 patients. Membrano proliferative glomerulonephritis (< PGN) occurred in nine patients; seven (78%) of them were HCV +ve compared to 29% HCV +ve in the whole group (117/399) (P