Kidney transplantation from donors with viral B and C hepatitis

Transplant Proc. 2006 May;38(4):996-8. doi: 10.1016/j.transproceed.2006.03.049.

Abstract

Introduction: The success of renal transplantation as a treatment for end-stage renal disease has created a chronic shortage of donor organs. We present our experience in transplanting kidneys from donors with hepatitis B virus (HBV) or hepatitis C virus (HCV) among matched serology-positive recipients.

Materials and methods: From January 2002 to November 2005, 44 patients with end-stage renal disease and HCV seropositivity underwent kidney transplantation. In 28 transplants in HCV+ recipients, the donor was HCV+ (DC+/RC+) and in 16 of these cases the donor (one living donor) was HCV- (DC-/RC+). In the same period 14 patients with HBV infection and HbsAg seropositivity underwent kidney transplantation: eight received their graft from a cadaveric HbsAg-positive donor (DB+/RB+), while six patients received their graft from an HbsAg-negative donor.

Results: Viral reactivation was higher among DC+/RC+ (21.4%) than DC-/RC+ patients (6%). Graft survivals were 90% and 88% for DC+/RC+ and DC-/RC+, respectively; patient survivals were 100% for DC+/RC+ and 94% for DC-/RC+. Among the group of DB+/RB+, all the patients developed an HBV-DNA positivity in the early postoperative period. Patient and graft survivals were 100% in both groups.

Conclusions: Our results suggest that HBV- and HCV-positive donors can be considered as an alternative donor source, because their kidneys are allocated to the matched serology-positive recipients, shortening their time on the waiting list.

MeSH terms

  • Adult
  • DNA, Viral / isolation & purification
  • Female
  • Hepacivirus / growth & development
  • Hepacivirus / isolation & purification
  • Hepatitis B / complications*
  • Hepatitis B virus / growth & development
  • Hepatitis B virus / isolation & purification
  • Hepatitis C / complications*
  • Humans
  • Kidney Transplantation / methods*
  • Kidney Transplantation / mortality
  • Male
  • Middle Aged
  • RNA, Viral / isolation & purification
  • Survival Analysis
  • Tissue Donors / statistics & numerical data*
  • Treatment Outcome
  • Virus Replication

Substances

  • DNA, Viral
  • RNA, Viral