Pretransplant hepatitis C virus infection and its effect on the post‐transplant course of living renal allograft recipients

Background: Hepatitis C virus infection (HCV) is a main health problem in end‐stage renal disease (ESRD) patients. The effect of pretransplant HCV infection on survival among ESRD patients who have undergone renal transplantation is controversial. We report the results of a large monocenter study that evaluated the effect of hepatitis C on the patient, and on graft survival in renal‐transplanted patients who received living donated allograft. Methods: A historical cohort study, we investigated all 1006 patients who received a living kidney transplant at Baghiatollah Medical Center in Tehran, Iran, between March 1995 and October 2001 (up to 85 months follow up). Patients’ sera had been routinely assayed for anti‐HCV antibodies and hepatitis B surface antigen (HBsAg) at the time of transplantation. The HBsAg‐positive patients were excluded from the survival analysis. Survivals were examined using Kaplan–Meier analysis and compared using the log–rank test. Multivariate analysis was performed using Cox's model. Results: Forty‐five patients (4.5%) were anti‐HCV‐antibody positive. Anti‐HCV‐antibody‐positive patients spent a longer time on dialysis and had a higher rate of retransplantation. There were no differences in recipients’ sex and age and donors’ age between the two groups. The 7‐year patient survival rate was 89.9% in the anti‐HCV‐antibody‐positive group and 95.5% in the HCV‐negative group ( P  = 0.74). Seven‐year graft survival was 82.0% and 75.0% in the anti‐HCV‐antibody‐positive and HCV‐negative groups, respectively ( P  = 0.39). In the multivariate analysis, age was the only significant parameter correlated with patient survival ( P  = 0.02). Conclusions: HCV infection does not seem to influence patient and graft survival within a medium‐time follow up in living allograft recipients, and anti‐HCV‐antibody positive status (alone) is not a contraindication for renal transplantation. However, further studies are needed to better define the role of HCV infection in long‐term prognosis. © 2003 Blackwell Publishing Asia Pty Ltd