Savas Nurten, Colak Turan, Selcuk Haldun, Yilmaz Ugur, Haberal Mehmet
Faculty of Medicine, Baskent University, Ankara, Turkey.
Dig Dis Sci. 2007 Dec;52(12):3440-3. doi: 10.1007/s10620-006-9714-z. Epub 2007 Apr 5.
The outcome of renal transplantation is adversely affected by hepatitis B virus infection. We retrospectively analyzed data of 1,251 renal transplant recipients, 20 of whom were hepatitis B surface antigen positive and hepatitis B virus DNA negative at the time of renal transplantation. Hepatitis B virus reactivation was seen in 14 of the 20 patients at a mean time of 16.3+/-7.1 months after transplantation. All patients with hepatitis B virus reactivation after transplantation were treated with lamivudine, biochemical, and serologic response was achieved in 13 of 14 patients at a mean time of 7.0+/-1.1 months. Seven of 13 patients experienced a breakthrough at a mean time of 9.2+/-6.2 months. Three of the 20 patients died at a mean time of 57.0+/-38.5 months after transplantation. Our data demonstrated that chronic immunosuppression is associated with a significantly high risk of hepatitis B virus reactivation in renal transplant recipients and hepatitis B reactivation does not increase the likelihood of graft rejection or patient mortality after renal transplantation.
肾移植的结局受到乙型肝炎病毒感染的不利影响。我们回顾性分析了1251例肾移植受者的数据，其中20例在肾移植时乙型肝炎表面抗原阳性但乙型肝炎病毒DNA阴性。20例患者中有14例出现乙型肝炎病毒再激活，移植后平均时间为16.3±7.1个月。所有移植后发生乙型肝炎病毒再激活的患者均接受拉米夫定治疗，14例患者中有13例在平均7.0±1.1个月时实现了生化和血清学反应。13例患者中有7例在平均9.2±6.2个月时出现突破。20例患者中有3例在移植后平均57.0±38.5个月时死亡。我们的数据表明，慢性免疫抑制与肾移植受者乙型肝炎病毒再激活的显著高风险相关，并且乙型肝炎再激活不会增加肾移植后移植排斥或患者死亡的可能性。
