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

Joon Ahn Hyung, Soo Kim Myoung, Seun Kim Yu, Il Kim Soon, Ha Huh Kyu, Ki Ju Man, Hoon Ahn Sang, Kwang Hyub Han

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

The clinical outcomes of 2,054 renal recipients were examined retrospectively based on pretransplant hepatitis B surface antigen (HBsAg) status to investigate the efficacy of lamivudine treatment in HBsAg positive recipients. Pretransplant 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 posttransplant 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.

Original languageEnglish
Pages (from-to)1655-1663
Number of pages9
JournalJournal of Medical Virology
Volume79
Issue number11
DOIs
Publication statusPublished - 2007 Nov 1

Fingerprint

Hepatitis B Surface Antigens
Lamivudine
Kidney Transplantation
Transplants
Graft Survival
Kidney
Liver
Viral Load
Hepatitis B virus
Chronic Kidney Failure
Survival Rate
Polymerase Chain Reaction
Incidence
Enzymes
adefovir

All Science Journal Classification (ASJC) codes

  • Virology
  • Infectious Diseases

Cite this

Hyung, Joon Ahn ; Myoung, Soo Kim ; Yu, Seun Kim ; Soon, Il Kim ; Kyu, Ha Huh ; Man, Ki Ju ; Sang, Hoon Ahn ; Han, Kwang Hyub. / Clinical outcome of renal transplantation in patients with positive pre-transplant hepatitis B surface antigen. In: Journal of Medical Virology. 2007 ; Vol. 79, No. 11. pp. 1655-1663.
@article{7b028b9323a64c08a7d57ab4384e2eab,
title = "Clinical outcome of renal transplantation in patients with positive pre-transplant hepatitis B surface antigen",
abstract = "The clinical outcomes of 2,054 renal recipients were examined retrospectively based on pretransplant hepatitis B surface antigen (HBsAg) status to investigate the efficacy of lamivudine treatment in HBsAg positive recipients. Pretransplant 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 posttransplant 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.",
author = "Hyung, {Joon Ahn} and Myoung, {Soo Kim} and Yu, {Seun Kim} and Soon, {Il Kim} and Kyu, {Ha Huh} and Man, {Ki Ju} and Sang, {Hoon Ahn} and Han, {Kwang Hyub}",
year = "2007",
month = "11",
day = "1",
doi = "10.1002/jmv.20980",
language = "English",
volume = "79",
pages = "1655--1663",
journal = "Journal of Medical Virology",
issn = "0146-6615",
publisher = "Wiley-Liss Inc.",
number = "11",

}

Clinical outcome of renal transplantation in patients with positive pre-transplant hepatitis B surface antigen. / Hyung, Joon Ahn; Myoung, Soo Kim; Yu, Seun Kim; Soon, Il Kim; Kyu, Ha Huh; Man, Ki Ju; Sang, Hoon Ahn; Han, Kwang Hyub.

In: Journal of Medical Virology, Vol. 79, No. 11, 01.11.2007, p. 1655-1663.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical outcome of renal transplantation in patients with positive pre-transplant hepatitis B surface antigen

AU - Hyung, Joon Ahn

AU - Myoung, Soo Kim

AU - Yu, Seun Kim

AU - Soon, Il Kim

AU - Kyu, Ha Huh

AU - Man, Ki Ju

AU - Sang, Hoon Ahn

AU - Han, Kwang Hyub

PY - 2007/11/1

Y1 - 2007/11/1

N2 - The clinical outcomes of 2,054 renal recipients were examined retrospectively based on pretransplant hepatitis B surface antigen (HBsAg) status to investigate the efficacy of lamivudine treatment in HBsAg positive recipients. Pretransplant 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 posttransplant 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.

AB - The clinical outcomes of 2,054 renal recipients were examined retrospectively based on pretransplant hepatitis B surface antigen (HBsAg) status to investigate the efficacy of lamivudine treatment in HBsAg positive recipients. Pretransplant 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 posttransplant 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.

UR - http://www.scopus.com/inward/record.url?scp=34748852140&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34748852140&partnerID=8YFLogxK

U2 - 10.1002/jmv.20980

DO - 10.1002/jmv.20980

M3 - Article

C2 - 17854044

AN - SCOPUS:34748852140

VL - 79

SP - 1655

EP - 1663

JO - Journal of Medical Virology

JF - Journal of Medical Virology

SN - 0146-6615

IS - 11

ER -