Unal E, Turkmen F, Sevinc C, Kiziler A R, Aydemir B, Titiz I
Department of General Surgery and Transplantation Unit, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Transplant Proc. 2006 Dec;38(10):3448-50. doi: 10.1016/j.transproceed.2006.10.150.
The aim of the present study was to investigate the impact of hepatitis C virus (HCV) infection on the long-term survival of renal transplant recipients.
Outcomes and survivals among 325 patients who received renal allografts from July 1991 to September 2005 were compared between those known to have pretransplantation HCV infection (Group I, HCV+ group, n = 33) versus a matched cohort of those without this infection (Group II, HCV- control group, n = 33). Allograft performance, liver function, cholesterol, and glucose levels were determined both at transplantation and at a mean of postgrafting year 8. A one-way analysis of variance (ANOVA) statistical method was used for multivariate analysis.
Thirty-three patients (10.15%, 19 women and 14 men) were positive for HCV antibody. The mean follow-up period was 8 years (range, 0.5-14 years). The mean survival rates were similar in Groups I and II (96.6% and, 100%, respectively). Although the allograft survival rate was lower in Group I (84.8% vs 90.9%), the rejection rate among the HCV- group was 6%; only 1 patient died of hepatic failure. In spite of a significant rise in both total and direct bilirubin values (P < .01) in both groups, we failed to observe an adverse effect on graft survival. A significant rise in the fasting glucose level was seen in both HCV+ and HCV- patients.
Chronic HCV infection before transplantation did not have a significant impact on graft survival or mortality compared with noninfected patients.
本研究的目的是调查丙型肝炎病毒（HCV）感染对肾移植受者长期生存的影响。
比较了1991年7月至2005年9月期间接受同种异体肾移植的325例患者的结局和生存率，其中已知有移植前HCV感染的患者（第一组，HCV阳性组，n = 33）与匹配的无此感染的队列（第二组，HCV阴性对照组，n = 33）。在移植时和移植后平均8年时测定同种异体移植物功能、肝功能、胆固醇和血糖水平。采用单因素方差分析（ANOVA）统计方法进行多变量分析。
33例患者（10.15%，19名女性和14名男性）HCV抗体呈阳性。平均随访期为8年（范围0.5 - 14年）。第一组和第二组的平均生存率相似（分别为96.6%和100%）。虽然第一组的同种异体移植物生存率较低（84.8%对90.9%），但HCV阴性组的排斥率为6%；仅1例患者死于肝功能衰竭。尽管两组的总胆红素和直接胆红素值均显著升高（P < 0.01），但我们未观察到对移植物生存的不利影响。HCV阳性和HCV阴性患者的空腹血糖水平均显著升高。
与未感染患者相比，移植前的慢性HCV感染对移植物生存或死亡率没有显著影响。
