HEPATITIS C INFECTION CONFERS INCREASED RISK OF IMMUNOLOGIC FAILURE FOLLOWING RENAL TRANSPLANTATION.

Abstract

138 Introduction. It has been observed that hepatitis C (HCV) infection confers an increased risk of acute rejection following liver transplantation. We examined our experience in renal transplantation with patients seropositive for HCV at the time of transplant, to assess the influence of HCV on immunologic outcome. Methods. We performed 180 transplants at our center from January 1, 1996 to December 31, 1997. We reviewed 88 adult recipients of primary cadaveric renal transplants. 73 patients were HCV negative; 15 were HCV Ab positive. None of the seropositive patients exhibited clinical signs of liver disease. We do not use HCV positive kidneys for HCV negative recipients; however, two seropositive patients received kidneys from HCV Ab positive donors. Our standard immunosuppression protocol is cyclosporine (CsA)/azathioprine/prednisone without induction therapy. CsA levels are titrated to 200-400 ng/ml postoperatively and are not adjusted for the presence of HCV infection. Results.(Table)TableConclusions. Our data, based on a retrospective review of renal transplant recipients with a minimum of 1 year follow-up, suggests that hepatitis C infection confers increased risk of acute rejection and graft loss. This phenomenon has also been observed in liver transplant patients. These data should prompt further investigation of the mechanism by which hepatitis C infection confers this increased immunologic risk.