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Clinical outcome of renal transplantation in patients with positive pre-transplant hepatitis B surface antigen

Authors
 Hyung Joon Ahn  ;  Myoung Soo Kim  ;  Kwang-Hyub Han  ;  Sang Hoon Ahn  ;  Man Ki Ju  ;  Kyu Ha Huh  ;  Soon Il Kim  ;  Yu Seun Kim 
Citation
 Journal of Medical Virology, Vol.79(11) : 1655-1663, 2007 
Journal Title
 Journal of Medical Virology 
ISSN
 0146-6615 
Issue Date
2007
Abstract
The clinical outcomes of 2,054 renal recipients were examined retrospectively based on pre-transplant hepatitis B surface antigen (HBsAg) status to investigate the efficacy of lamivudine treatment in HBsAg positive recipients. Pre-transplant HBsAg positivity was documented in 66 recipients. The 10-year patient and graft survival rates in Ag positive group were significantly lower than those of Ag negative group (64.4/36.6% vs. 88.2/70.5%, respectively, P < 0.0001). Since 1997, lamivudine was used when hepatitis B virus polymerase chain reaction (HBV PCR) was positive or when the level of post-transplant viral load rose. Lamivudine given to 27 recipients markedly improved both 10-year patient and graft survivals compared to Ag positive renal recipients who did not take lamivudine (85.3/59.2% vs. 49.9/22.7%, respectively, P < 0.0001). Overall, 13 viral breakthroughs among 24 lamivudine-responsive patients were observed. The cumulative incidence of viral breakthrough at 60 months was 53.3%. Adefovir rescue in three viral breakthroughs patients induces virological response and restoration of liver function. In 10 patients who did not changed to adefovir, 6 patients are alive with elevated liver enzymes. In conclusion, in the era of lamivudine and adefovir, renal transplantation in HBsAg positive end-stage renal disease patients should not be abandoned
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/jmv.20980/abstract
DOI
10.1002/jmv.20980
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Orofacial Pain and Oral Medicine (구강내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
김명수(Kim, Myoung Soo) ORCID logo https://orcid.org/0000-0002-8975-8381
김순일(Kim, Soon Il) ORCID logo https://orcid.org/0000-0002-0783-7538
김유선(Kim, Yu Seun) ORCID logo https://orcid.org/0000-0002-5105-1567
안상훈(Ahn, Sang Hoon) ORCID logo https://orcid.org/0000-0002-3629-4624
안형준(Ahn, Hyoung Joon)
주만기(Joo, Man Ki) ORCID logo https://orcid.org/0000-0002-4112-7003
한광협(Han, Kwang-Hyub) ORCID logo https://orcid.org/0000-0003-3960-6539
허규하(Huh, Kyu Ha) ORCID logo https://orcid.org/0000-0003-1364-6989
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/96477
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