Sezer Siren, Ozdemir Fatma Nurhan, Akcay Ali, Arat Zubeyde, Boyacioglu Sedat, Haberal Mehmet
Department of Nephrology, Faculty of Medicine, Baskent University, Ankara, Turkey.
Clin Transplant. 2004 Oct;18(5):619-23. doi: 10.1111/j.1399-0012.2004.00252.x.
Sezer S, Ozdemir FN, Akcay A, Arat Z, Boyacioglu S, Haberal M. Renal transplantation offers a better survival in HCV-infected ESRD patients. Clin Transplant 2004 DOI: 10.1111/j.1399-0012.2004.00252. Abstract: The presence of hepatitis C virus (HCV) infection has been found to adversely affect the morbidity and mortality rates in the dialysis population. Renal transplantation is a treatment option after a careful pre-transplant evaluation. We designed this study to find the impact of HCV infection on patient survival, co-morbidity and allograft survival in a selected group of hemodialysis (HD) and transplant population. We retrospectively analyzed 116 renal transplant patients (94 HCV-negative, 22 HCV-positive) and 136 HD patients (106 HCV-negative, 30 HCV-positive) who had renal transplantation or underwent dialysis before 1996. The HCV-infected patients were evaluated by liver biopsy for the absence of advanced liver disease before transplantation. There was no clinical or laboratory decompensation of liver disease in transplant and dialysis patient groups. The overall 5-yr survival rates were 85.2% for renal transplant recipients and 74.5% for those on HD. The comparison results revealed a significant difference between HCV-infected patients with and without transplantation. The 3-yr renal allograft survival rates were comparable in HCV-positive and -negative patients, but the risk of chronic allograft nephropathy (CAN) and graft failure were higher at the fifth year in HCV-positive patients. In conclusion, renal transplantation should the preferred therapy in HCV-infected dialysis patients as it improves the survival rates. The presence of HCV infection increases the CAN rate and the influence on allograft survival is evident at the fifth year of assessment.
塞泽尔 S、奥兹德米尔 FN、阿克恰伊 A、阿拉特 Z、博亚乔格鲁 S、哈贝勒尔 M。肾移植为丙型肝炎病毒（HCV）感染的终末期肾病（ESRD）患者提供了更好的生存率。《临床移植》2004 年 DOI: 10.1111/j.1399-0012.2004.00252。摘要：已发现丙型肝炎病毒（HCV）感染的存在对透析人群的发病率和死亡率有不利影响。肾移植是经过仔细的移植前评估后的一种治疗选择。我们设计这项研究以发现 HCV 感染对一组选定的血液透析（HD）和移植人群中患者生存率、合并症及移植肾生存率的影响。我们回顾性分析了 1996 年前接受肾移植或透析的 116 例肾移植患者（94 例 HCV 阴性，22 例 HCV 阳性）和 136 例 HD 患者（106 例 HCV 阴性，30 例 HCV 阳性）。HCV 感染患者在移植前通过肝活检评估是否存在晚期肝病。移植组和透析组患者均无临床或实验室检查提示的肝病失代偿情况。肾移植受者的总体 5 年生存率为 85.2%，HD 患者为 74.5%。比较结果显示，HCV 感染患者移植与否存在显著差异。HCV 阳性和阴性患者的 3 年移植肾生存率相当，但 HCV 阳性患者在第 5 年发生慢性移植肾肾病（CAN）和移植失败的风险更高。总之，肾移植应是 HCV 感染透析患者的首选治疗方法，因为它能提高生存率。HCV 感染的存在会增加 CAN 发生率，且在评估的第 5 年对移植肾生存率的影响明显。
