C형 간염 항체 양성인 말기 신부전증 환자에서 신이식후의 임상경과에 관한 연구

Abstract

This study showed that the anti-HCV(+) recipients had higher incidence of post-transplant hepatic dysfunction than the anti-HCV(-) recipients, which was consistent with previous reports. There have been conflicting reports on the rate of acute rejection, extra-hepatic infection, and mortality from hepatic failure in anti-HCV(+) recipients. In our study, there were no significant differences in these parameters between the anti-HCV(+) and (-) recipients. As the possible explanation for conflicting reports, the variability in HCV strain virulence, viral burden and different immunosuppressive regimen can be suggested. The greater number of acute rejection was observed in the recipients with normal histology, but studies in a larger number of patients should be needed for confirmation. The graft and patient survival in anti-HCV(+) recipients were not significantly different from those in anti-HCV(-) recipients in short-term follow-up. There was also no difference in graft or patient survival between CPH and carrier status recipients. From these results, it seems that anti-HCV(+) is not a poor prognostic indicator. Two HCV-RNA(+) recipients maintained relatively stable liver function, suggesting the low sensitivity of liver enzymes to detect active viral replications. In conclusion, the graft and patient survival appear not to be influenced by anti-HCV status in short-term follow-up, but long-term follow-up with close monitoring should be required in view of the increased risk for posttransplant hepatic dysfunction.