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Serial measurements of serum transaminases in renal transplant recipients with chronic hepatitis C: do they reflect disease severity?
Author(s) -
Besisik Fatih,
Sükrü Sever Mehmet,
Dincer Dinc,
Çevikbas Ugur,
Türkoglu Salih,
Çakaloglu Yılmaz,
Kaymakoglu Sabahattin,
Ökten Atilla
Publication year - 2000
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1034/j.1399-0012.2000.140603.x
Subject(s) - medicine , gastroenterology , elevated transaminases , liver biopsy , cirrhosis , hepatitis , liver function tests , liver disease , chronic liver disease , hepatitis c , alanine transaminase , transaminase , aspartate transaminase , liver function , kidney disease , renal function , biopsy , alkaline phosphatase , biochemistry , chemistry , enzyme
Chronic hepatitis C infection is a common problem in renal allograft recipients. This study was designed to investigate the association of serum aminotransferase levels with liver histology, in renal transplant patients with chronic hepatitis C virus (HCV) infection, in the long term.
Methods. In this study, 82 HCV‐infected renal allograft recipients, who were followed up with functioning grafts for at least 6 months, were analyzed. Patients were classified according to their transaminase values as persistently normal, intermittently abnormal, or continuously abnormal liver function tests. Serum transaminase levels exceeding at least 1.5 times the upper limit of normal (40 IU) for periods longer than 1 month were taken as abnormal. Patients with abnormal liver function tests owing to HCV unrelated causes (drugs, alcohol, or other toxic substances, other viruses, etc.) were excluded from the study. Forty‐eight of these patients underwent at least one liver biopsy.
Results. Of the 82 patients, 34 (41.5%) had persistently normal (liver biopsy revealed normal or minimal changes in 77.0%, chronic persistent hepatitis in 15.3%, chronic active hepatitis in 7.7%; no patient had cirrhosis), 29 (35.3%) intermittently abnormal (liver histology was consistent with minimal changes in 50%, chronic persistent hepatitis in 27.8%, chronic active hepatitis in 16.7%, cirrhosis in 5.5%), 19 (23.2%) persistently abnormal (liver biopsy showed minimal changes in 41.1%, chronic persistent hepatitis in 17.6%, chronic active hepatitis in 35.3%, cirrhosis in 5.9%) transaminase values.
Conclusion. Although continuously or intermittently elevated transaminases do not always indicate morphologically advanced disease, the normal course of serum transaminases is mostly accompanied by normal, or near‐normal, liver histology, in HCV‐infected renal transplant patients. Liver biopsy is not indicated in deciding disease severity in these patients unless clinical findings dictate otherwise.