Background: Hepatitis C (HCV) Infection is not uncommon in patients on maintenance hemodialysis (around 10% in our dialysis population). It is also known to increase morbidity and mortality in Renal Allograft Recipients more so in post-transplant period with various studies quoting mixed results.
Aim: To find the impact of HCV infection on graft and patient survival and to compare the incidence of rejection, infections, liver dysfunction, NODAT(New Onset Diabetes after Transplantation) in HCV infected and negative patients.
Setting and Design: Retrospective and prospective institutional based study.
Method: HCV RNA positive patients without portal hypertension/abnormal liver scan were included in the study. Patients were divided into three groups on the basis of whether or not they received anti HCV treatment and how they responded to it.
Results and Conclusion: Patients who are anti-HCV positive before transplantation have a significantly increased risk of post-transplant liver disease. Most of the literature quotes a relative risk of 5 and an incidence of 19%-64% for post-transplant liver disease.(Vs. 1%-30% for general population) In our study 15% of patients had deranged liver function post-transplant however none of these patients showed any sign of decompensation. Confl icting results surround the question as to whether post-transplant liver disease is associated with decreased survival. As an example, three studies failed to detect significant differences in patient survival between recipients with and without anti-HCV prior to renal transplantation. The same fact is also highlighted in our study where in there were no graft loss and the patient survival were comparable to our regular cohort at 1 and 5 year post transplant. Rejection rate were higher compared to regular cohort particularly in modern era. As such renal transplant is a safe and viable option in HCV + patients with or without anti HCV treatment pretransplant medically, financially, socially and physically.
Published on: Mar 31, 2017 Pages: 4-8
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