The Clinic Study To The Effect Of HCV Infection On Kidney Transplantation Outcome

Objective:To study the effect of HCV infection on kidney- transplantation outcome and offer some new opinions and measures for the clinic practice in kidney-transplantation field.Methods:We retrospectively studied all the 2100 patients who received a kidney transplantation (from cadaveric donors) at the Nan Fang Hospital from January 1992 to December2002. 86 recipients were selected from the whole and they were fixed on with the qualifications: (1)anti-HCV was positive or anti-HCV was doubtable positive and HCV-RNA was positive before transplantation(2) HBsAg was negative pre-transplantation(3) patients received the first kidney transplantation. We selected another 86 patients for comparison and made two groups uniform only but HCV infection. Anti-HCV-positive was confirmed by enzyme-linked immunosorbance assay (ELISE). Positivity of HCV-RNA was confirmed by RT-PCR. The Recipient /Graft survival in 1-year, 3-year, and 5-year, the rate of Acute/Chronic Rejection occurring and cause of death were compared between two groups. The data of the study were computed in SPSS. 10.0, and the x2 test was used to compare qualitative values.Results:Our results clearly indicated that the kidney transplant recipients with HCV had a significantly reduced 5-years recipient survival ( 74.4% ) compared with the recipients without HCV(87.2%, p<0.01).The 1-year survival (94.2% /90.1% and 96.8%/96.0%)and 3-year survival (88.4%/79.1% and 90.7%/87.2%) of the recipient/graft, the rate of acute/chronic rejection occurring (31.3% and 21.2% /12.5% and 6.5%) and the 5-year graft survival (73.3%/81.4%) were not different between the two groups (p>0.05). Increased mortality was primarily caused by liver disease.Conclusions:These results suggest that HCV infection has a harmful long-term impact on the survivals of the kidney -transplantation recipients, and the kidney-transplantation should be forbidden for the patients of HCV infection relatively.