Brown Kristian L, El-Amm Jose M, Doshi Mona D, Singh Atul, Morawski Katherina, Cincotta Elizabeth, Siddiqui Firdous, Losanoff Julian E, West Miguel S, Gruber Scott A
Section of Transplant Surgery, Department of Surgery, Wayne State University School of Medicine, Detroit, MI 48201, USA.
Am J Surg. 2008 Mar;195(3):298-302; discussion 302-3. doi: 10.1016/j.amjsurg.2007.12.005.
Prior studies have yielded conflicting results concerning the impact of HCV on renal transplant outcomes.
We examined outcomes in comparable groups of predominantly African American hepatitis C virus (HCV)-positive (n = 34) and HCV-negative (n = 111) kidney transplant patients receiving contemporary immunosuppression.
There was no difference in patient survival or acute rejection, but new-onset diabetes (NODM) was increased and graft survival decreased in the HCV-positive group, with increased graft loss secondary to noncompliance and Type I MPGN. The incidence of NODM among patients undergoing early corticosteroid withdrawal was 11% in both groups, while among those on prednisone, it was 47% in HCV-positive versus 25% in HCV-negative recipients.
Deceased-donor HCV-positive renal allograft recipients have equivalent patient but decreased graft survival. Noncompliance and Type I MPGN play a role in producing this negative effect on graft outcome. Steroids may be required for HCV to exert its diabetogenicity in kidney transplant patients.
