Carbone Marco, Cockwell Paul, Neuberger James
Liver Unit, Queen Elizabeth Hospital, Birmingham B15 2TH, UK.
Int J Nephrol. 2011;2011:593291. doi: 10.4061/2011/593291. Epub 2011 Jun 28.
Hepatitis C virus (HCV) infection is relatively common among patients with end-stage kidney disease (ESKD) on dialysis and kidney transplant recipients. HCV infection in hemodialysis patients is associated with an increased mortality due to liver cirrhosis and hepatocellular carcinoma. The severity of hepatitis C-related liver disease in kidney transplant candidates may predict patient and graft survival after transplant. Liver biopsy remains the gold standard in the assessment of liver fibrosis in this setting. Kidney transplantation, not haemodialysis, seems to be the best treatment for HCV+ve patients with ESKD. Transplantation of kidneys from HCV+ve donors restricted to HCV+ve recipients is safe and associated with a reduction in the waiting time. Simultaneous kidney/liver transplantation (SKL) should be considered for kidney transplant candidates with HCV-related decompensated cirrhosis. Treatment of HCV is more complex in hemodialysis patients, whereas treatment of HCV recurrence in SLK recipients appears effective and safe.
丙型肝炎病毒（HCV）感染在接受透析的终末期肾病（ESKD）患者和肾移植受者中相对常见。血液透析患者中的HCV感染与肝硬化和肝细胞癌导致的死亡率增加有关。肾移植候选者中丙型肝炎相关肝病的严重程度可能预测移植后的患者和移植物存活情况。在这种情况下，肝活检仍是评估肝纤维化的金标准。对于患有ESKD的HCV阳性患者，肾移植而非血液透析似乎是最佳治疗方法。将来自HCV阳性供体的肾脏移植限制于HCV阳性受者是安全的，并且与等待时间的缩短有关。对于患有HCV相关失代偿性肝硬化的肾移植候选者，应考虑同时进行肾/肝移植（SKL）。血液透析患者的HCV治疗更为复杂，而SLK受者中HCV复发的治疗似乎有效且安全。
