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Korean J Nephrol. 2002 May;21(3):423-434. Korean. Original Article.
Bang BK , Choi BS , Kim HW , Kim SK , Yang CW , Kim YS , Kim SY , Choi EJ , Chang YS .
Department of Internal Medicine, Medical College, The Catholic University of Korea, Seoul, Korea.

BACKGROUND: The impact of hepatitis B or hepatitis C virus infection on renal transplantation outcome is controversial. The aim of this study is to assess the impact of hepatitis B and hepatitis C infection on kidney transplant over the long-term, 15 years and to compare infected patients with noninfected patients matched for factors possibly associated with graft and patient survival. METHODS: We analyzed 1,042 patients who underwent renal transplantation in period from March 1984 to Dec. 1998 including 107 with positive HBsAg (HBV(+) group), 81 with positive anti-HCV antibody (HCV(+) group) and 714 noninfected recipients (NBNC group). One hundred-forty patients who had not taken ani-HCV antibody screening test were excluded. The prevalence of chronic liver disease, the patient mortality, the patient survival rate and the graft survival rate were evaluated. RESULTS: The patient mortality during the period of follow-up was significantly higher in HBV(+) group(32.7%) than in HCV(+) group(9.9%) and NBNC group(8.4%). The cause of death related to liver desease was significantly higher in HBV(+) group(57.1%) than HCV(+) group(0%) and NBNC group(1.7%). Five year and 10 year graft survival rate were significantly lower in HBV(+) group(52.2 %, 39.2%) than in HCV(+) group(68.4%, 47.2%) and NBNC group(86.6%, 65.8%). Five year and 10 year patient survival rate of HBV(+) group(72.0%, 68.9%) was significantly lower than HCV(+) group(91.6%, 87.3%) and NBNC group(94.4%, 88.2%), but there was no significant difference in the patient survival rate between HCV(+) and NBNC group. CONCLUSION: Hepatitis B virus infection has a significant deleterious effect on the patient and graft survival of renal transplantation recipients. The poor survival rate was a result of the mortality from liver disorder. Hepatitis C virus infection also has a poor graft survival rate compared to NBNC group, but the patient survial rate is similar to NBNC group.

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