B형 간염 항원 ( HBsAg ) 양성인 말기 신부전증 환자에서 신이식 후의 임상 경과에 관한 연구

Abstract

The impact of HBsAg on the clinical outcome of renal transplantation has been controversial and few of the reports included the pre-operative liver biopsy findings. Our results concerning the deletrious effect of HBsAg on the graft and patient survival are in agreement with the majority of recent studies. It seems that more chronic hepatitis and extrahepatic infection, probably due to immunosuppression, led to these results. HBsAg(+) patients with CPH had worse graft and patient survival as expected. And the graft survival in the carrier group was also inferior to that in the HBsAg(-) recipients. It raises the question of whether HBsAg(+) patient, even with no evidence of hepatitis on liver biopsy, should be a candidate for renal transplantation. In summary, HBsAg(+) recipients are at increased risk for development of chronic hepatitis, extrahepatic infection, graft failure and death from hepatic failure after renal transplantation. Therefore, a careful follow-up for LFT as well as renal function tests in HBsAg(+) recipients will be necessary even though the pre-operative liver biopsy reveals no evidence of hepatitis.