Asif Madiha, Hanif Farina Muhammad, Luck Nasir Hassan, Tasneem Abbas Ali
From the Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan.
Exp Clin Transplant. 2019 Jan;17(Suppl 1):202-206. doi: 10.6002/ect.MESOT2018.P66.
The preferred modality for renal replacement therapy is renal transplantation. Marked improvements in early graft survival and long-term graft function have made renal transplantation a more cost-effective alternative to dialysis. The presence of liver disease in the posttransplant period adversely affects graft function and survival. Determining the cause of deranged liver function tests can be helpful in treating the underlying cause, leading to improved graft survival and overall quality of life in patients after renal transplant. Here, we determined the frequency of hepatotropic viral infections leading to deranged liver function tests in renal transplant recipients.
Our study included 132 patients with deranged liver function tests who had undergone renal transplant within the past 6 months. Reactivity and nonreactivity of hepatotropic viruses leading to deranged liver function tests were recorded.
Average age of patients was 37.17 ± 8.75 years. There were 84 male (63.64%) and 48 female (36.36%) patients. Rates of hepatitis C virus antibodies and hepatitis B surface antigen were 62.88% (83/132) and 37.12% (49/132), respectively, whereas no patients had hepatitis E virus immunoglobulin M antibodies or hepatitis A virus immunoglobulin M antibodies.
Among the hepatotropic viral infections leading to deranged liver function tests in renal transplant recipients, hepatitis B virus accounted for a small fraction. In contrast, hepatitis C virus was highly prevalent in transplant recipients who developed deranged liver function tests. Renal transplant recipients with hepatic viral infections have worse patient and allograft survival after transplant compared with noninfected renal transplant recipients. We recommend that transplant candidates be screened for hepatitis B and C virus infection, thus allowing increased graft survival and improved quality of life in renal transplant recipients.
肾脏替代治疗的首选方式是肾移植。早期移植物存活率和长期移植物功能的显著改善使肾移植成为比透析更具成本效益的选择。移植后期出现的肝脏疾病会对移植物功能和存活产生不利影响。确定肝功能检查异常的原因有助于治疗潜在病因，从而提高肾移植患者的移植物存活率和总体生活质量。在此，我们确定了导致肾移植受者肝功能检查异常的嗜肝病毒感染的频率。
我们的研究纳入了132例在过去6个月内接受肾移植且肝功能检查异常的患者。记录导致肝功能检查异常的嗜肝病毒的反应性和非反应性。
患者的平均年龄为37.17±8.75岁。有84例男性（63.64%）和48例女性（36.36%）患者。丙型肝炎病毒抗体和乙型肝炎表面抗原的发生率分别为62.88%（83/132）和37.12%（49/132），而没有患者有戊型肝炎病毒免疫球蛋白M抗体或甲型肝炎病毒免疫球蛋白M抗体。
在导致肾移植受者肝功能检查异常的嗜肝病毒感染中，乙型肝炎病毒占比小。相比之下，在出现肝功能检查异常的移植受者中，丙型肝炎病毒非常普遍。与未感染的肾移植受者相比，感染肝病毒的肾移植受者移植后的患者和移植物存活率更差。我们建议对移植候选人进行乙型和丙型肝炎病毒感染筛查，从而提高肾移植受者的移植物存活率并改善生活质量。
