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 language | English |
|---|---|
| Pages (from-to) | 1655-1663 |
| Number of pages | 9 |
| Journal | Journal of Medical Virology |
| Volume | 79 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - 2007 Nov 1 |
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All Science Journal Classification (ASJC) codes
- Virology
- Infectious Diseases
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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; 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 journal › Article
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 -