Hepatitis C, acute humoral rejection, and renal allograft survival

Details

Serval ID
serval:BIB_73D7D0F424A9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Hepatitis C, acute humoral rejection, and renal allograft survival
Journal
Journal of the American Society of Nephrology
Author(s)
Forman  J. P., Tolkoff-Rubin  N., Pascual  M., Lin  J.
ISSN
1046-6673
Publication state
Published
Issued date
12/2004
Peer-reviewed
Oui
Volume
15
Number
12
Pages
3249-55
Notes
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S. --- Old month value: Dec
Abstract
The effect of recipient hepatitis C virus (HCV) infection on renal allograft loss and acute rejection in kidney transplantation remains controversial. We studied 354 renal allograft recipients transplanted during 1996 to 2001 who had HCV antibodies (Ab) measured before transplantation. The primary outcome was death-censored allograft loss and the secondary outcome was acute humoral rejection (AHR). Compared with HCV Ab-negative patients, those with positive HCV Ab had longer time on dialysis before transplantation, higher percentage of panel-reactive antibodies (PRA), were more likely to receive a cadaveric transplant, and were more likely to develop delayed graft function (DGF). In univariate analyses, predictors of renal allograft loss included HCV, cadaveric graft, PRA >20%, HLA mismatch > or =5, retransplantation, DGF, induction therapy, and AHR. When adjusted for PRA >20%, HLA mismatch > or =5, and multiple transplant status, HCV was not a statistically significant predictor of allograft loss. HCV was also associated with AHR but lost significance when adjusted for PRA >20%. HCV Ab-positive patients were more likely to have longer duration of dialysis before transplantation prior to kidney transplants, higher PRA, and to receive cadaveric transplants. These characteristics likely resulted in more DGF and AHR after transplantation. After adjusting for these confounding factors, the association between HCV Ab positivity and renal allograft loss was notably attenuated and no longer statistically significant.
Keywords
Adult Female Graft Rejection/*mortality Hepatitis C/immunology/*mortality Hepatitis C Antibodies/blood Humans Kidney Failure, Chronic/*mortality Kidney Transplantation/*mortality Male Middle Aged Proportional Hazards Models Retrospective Studies Risk Factors Transplantation, Homologous
Pubmed
Web of science
Open Access
Yes
Create date
29/01/2008 13:52
Last modification date
20/08/2019 14:31
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