대한신장학회

논문분류	춘계학술대회 초록집
제목	Pretransplant Hepatitis B Viral Infection Increased Risk of Death after Kidney Transplantation
저자	Jeonghwan Lee1, Jang-Hee Cho2, Jung Nam An3, Chan-Duck Kim2, Curie Ahn5, In Mok Jung4, Duck Jong Han6, Chun Soo Lim3, Yon Su Kim5, Young Hoon Kim6, Jung Pyo Lee3
출판정보	2015; 2015(1):
키워드	신이식,B형간염,생존
초록	Background: Clinical outcomes have not been well evaluated in kidney transplant recipients (KTRs) with hepatitis B virus (HBV). Here, we aimed to investigate the recent posttransplant clinical outcomes in an HBV endemic country. Methods: Among 4897 Korean kidney recipients from Aril 1999 to December 2011, 4412 patients whose viral hepatitis serology data was available were enrolled. Numbers of patients with HBV and hepatitis C virus (HCV) were 209 (4.7%) and 83 (1.9%).We analyzed the clinical outcomes, including overall mortality, graft failure, and new-onset diabetes after transplantation (NODAT), among patients who had taken kidney transplantation. Results: Patients with HBV showed poorer survival than KTRs without HBV or HCV (p=0.004, HR=2.084, 95% CI 1.266-3.430). However HCV did not affect patient survival (p=0.119, HR=1.914, 95% CI 0.846-4.327). Patients with chronic hepatitis C showed increased incidence of graft failure (p<0.001, HR=2.271, 95% CI 1.481-3.480). The graft survival of patients with chronic hepatitis B was not different (p=0.773, HR=1.082, 95% CI 0.634-1.846) compared with the seronegative patients. Incidence of NODAT was not increased in patients with chronic hepatitis B (p=0.493, OR 1.180, 95% CI 0.734-1.897), but increased in patients with chronic hepatitis C (p=0.041, OR 1.993, 95% CI 1.027-3.869). Among causes of patient mortality in chronic hepatitis B, hepatic causes were more prominent (1 hepatic failure, 2 hepatocellular carcinoma; 20.0% vs. 0.8%, p<0.001) compared with patients without chronic hepatitis B. Patients with chronic hepatitis C and allograft failure showed increased trend of transplant rejection (83.3% vs. 68.6%, p=0.462), but the statistical significance was not proved. Pretransplantation liver biopsy and hepatitis B/C viral titer were not associated with post transplantation patient survival or graft loss. Conclusion: Kidney transplantation recipients with chronic hepatitis B could show poor survival due to post transplantation hepatic complications.
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