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

 Hyung Joon Ahn  ;  Myoung Soo Kim  ;  Kwang-Hyub Han  ;  Sang Hoon Ahn  ;  Man Ki Ju  ;  Kyu Ha Huh  ;  Soon Il Kim  ;  Yu Seun Kim 
 JOURNAL OF MEDICAL VIROLOGY, Vol.79(11) : 1655-1663, 2007 
Journal Title
Issue Date
Adolescent ; Adult ; Antiviral Agents/therapeutic use* ; Child ; Female ; Graft Survival* ; Hepatitis B/drug therapy ; Hepatitis B/mortality* ; Hepatitis B/virology ; Hepatitis B Surface Antigens/blood* ; Humans ; Kidney Transplantation/adverse effects ; Kidney Transplantation/mortality* ; Lamivudine/therapeutic use* ; Liver/pathology ; Liver Function Tests ; Male ; Middle Aged ; Reverse Transcriptase Inhibitors/therapeutic use* ; Survival Rate ; Treatment Outcome
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
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Orofacial Pain and Oral Medicine (구강내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, Soon Il(김순일) ORCID logo https://orcid.org/0000-0002-0783-7538
Kim, Yu Seun(김유선) ORCID logo https://orcid.org/0000-0002-5105-1567
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Ahn, Hyoung Joon(안형준)
Joo, Man Ki(주만기) ORCID logo https://orcid.org/0000-0002-4112-7003
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
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