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Hepatit-B ve C enfeksiyonlarının böbrek transplatasyonunda graft ve karaciğer fonksiyonlarına etkisi: Türkiye'den tek merkez deneyimi

Year 2021, Volume: 54 Issue: 3, 356 - 359, 01.01.2022
https://doi.org/10.20492/aeahtd.810818

Abstract

AMAÇ: İmmünsüpresif tedaviden dolayı hepatit-B veya C enfeksiyonlarının böbrek nakilli hastalarda graft ve hasta sağ kalımına olumsuz etki ettiği konusu tartışmalıdır. Çalışmamızın amacı böbrek nakilli hastalarda hepatit-B ve C enfeksiyonlarının hasta ve graft üzerine etkilerini değerlendirmektir.

GEREÇ VE YÖNTEMLER: Çalışmaya 66 böbrek nakil hastası alındı. Anti-HCVpozitif beş hasta ve Hbs-Ag pozitif dokuz hasta viral hepatit grubunu oluşturdu. Geri kalan 52 hasta (anti-HCV, Hbs-Ag negatif) viral hepatiti olmayan grubu oluşturdu. Hastane kayıtları retrospektif olarak tarandı. Nakil sonrası ilk üç yıllık AST, ALT, albumin, hesaplanmış glomerüler filtrasyon hızı (hGFH) not edildi.

BULGULAR: Transplant sonrası takip süresi ortalama olarak viral hepatit grubunda 62,4 ±48,2 ay viral hepatiti olmayan grupta 35,3±15,7 ay idi. Cinsiyet, donör tipi, yaş, transplant sonrası nakil süresi açısından iki grup arasında anlamlı fark yoktu. Sadece nakil öncesi diyaliz süresi hepatit grubunda anlamlı daha uzundu. hGFH (sırasıyla viral hepatit olmayan grupta 73,5±22,7, 69,3±23, 63,5±22,1 mL/dk, viral hepatit grubunda 78,8±15,7, 70,6±12,5, 61,2±13,1 mL/dk), AST, ALT, albumin birinci, ikinci, üçüncü yıllarda iki grupta benzerdi Ancak üçüncü yılın sonundaki hGFH'deki düşüş hızı ve AST/ALT’deki artış hızı viral hepatit grubunda istatistiksel olarak anlamlı daha fazlaydı. hGFH'deki düşüşün kadınlarda daha hızlı olduğu tespit edilirken, kolerasyon analizinde yaş ve nakil öncesi diyaliz süresinin hGFH'deki düşüşe etkisi bulunmadı.
SONUÇ: Üç yıllık takipte hGFH ve AST/ALT değerleri iki grupta benzerdi. Hiçbir hastada graft kaybı, karaciğer yetmezliği, ölüm gelişmedi. Günümüzde hepatit-C enfeksiyonu için başarılı tedaviler uygulanmakla birlikte anti viral tedavi uygulanmamış hepatiti pozitif olan son dönem böbrek yetmezlikli hastalarda böbrek nakli, iyi bir değerlendirme sonrası güvenli ve etkili bir tedavi seçeneği olarak kabul edilebilir.

References

  • 1-Hofmann CJ, Subramanian AK, Cameron AM. Incidence and risk factors for hepatocelluler carcinoma after solid organ transplantation. Transplantation. 2008;86:784-90
  • 2- Forman J, Tolkoff-Rubin N, Pascual M, et al. Hepatitis C, acute humaral rejection and renal allograft survival. J Am Soc Nephrol. 2004;15:3249-55
  • 3-Breitenfeldt MK, Rasenack J, Berthold H. Impact of hepatitis B and C on graft loss and mortality of patients after kidney transplantation. Clin Transplant. 2002;16:130-6
  • 4-Lee WC, Shu KH, Cheng CH. Long-term impact of hepatitis B, Cvirus infection on renal transplantation. Am J Nephrol. 2001; 21:300-6
  • 5-Santos L, Alves R, Macario F. Impact of hepatitis B, Cvirus infection on kidney transplantation: a single center experience. Transplant Proc. 2009;41:880-2
  • 6- Harmancı Ö, İlin S, Öcal S. The Effect of Hepatitis B Virus on Graft and Overall Survival in Kidney Transplant Patients. Exp Clin Transplant. 2015;13:36-40
  • 7- Hyodo N, Nakamura I, Imawari M. Hepatitis B core antigen stimulates ınterleukin-10 secretion by both T cells and monocytes from peripheral blood patients with chronic hepatitis B virus infection. Clin Exp Immunol. 2004;135:462-6
  • 8- Op den Brouw ML, Binda RS, van Roosmalen MH. Hepatitis B virus surface antigen impairs myeloid dendritic cell function: a possible immune escape mechanism of hepatitis B virus. Immunology. 2009;126:280-9
  • 9- Grenha V, Parada B, Ferreira C. Hepatitis B virus, hepatitis C virus, and kidney transplant acute rejection and survival. Transplant Proc. 2015;47:942-5
  • 10- Ridruejo E, Cusumano A, Diaz C. Hepatitis C virus infection and outcome of renal transplantation. Transplant Proc. 2007;39:3127-30
  • 11-Fontaine H, Arlic L, Labreuche J, et al.Control of replication of hepatitis B and C virus improves patient and graft survival in kidney transplantation. J Hepatol. 2019;70:831-8.
  • 12-Meyer CM. Hepatitis C and renal disease: an update. Am J Kidney Dis. 2003;42:631-57
  • 13-Morales JM, Mareen R, Andres A. Renal transplantation in patients with hepatitis C virus antibody. Along national experience. Nephrol Dial Tranplant. 2010;3:41-6
  • 14-Lee J, Cho JH, Lee JS. Pretransplant Hepatitis B Viral Infection Increases Risk of Death After Kidney Transplantation: A Multicenter Cohort Study in Korea. Medicine (Baltimore). 2016;95:e3671.
  • 15-Lai CL, Shoval D, Lok AS. Entecavir versus lamivudine for patients with HBeAg-negative chronic hepatitis B. N Engl J Med. 2006;354:1011-20
  • 16-Marcellin P, Heathcote EJ, Buti M. Tenofovir disoproxil fumarate versus adefovir dipivoxil for chronic hepatitis B. N Engl J Med. 2008;359:2442-55
  • 17-Yap DY, Tang CS, Yung S. Long-term outcome of renal transplant recipients with chronic hepatitis B infection-impact of antiviral treatment. Transplantation. 2010;90:325-30
  • 18-Nkongolo S, Ni Y, Lempp FA. Cyclosporin A inhibitis hepatitis B and hepatitis D virus entry by cyclophilin-independent interference with the NTCP receptor. J Hepatol. 2014;60:723-31
  • 19- Denewar AA, Monem El-Hendy YA, Wafa EW. The Long-Term Effect of Hepatitis C Virus on the Outcome of Live-Donor Kidney Transplant Recipients. A Retrospective Study.Exp Clin Transplant. 2015;13:402-7
  • 20- Carpio R, Pamugas GE, Danguilan R, Que E. Outcomes of Renal Allograft Recipients With Hepatitis C. Transplant Proc. 2016 ;48:836-9
  • 21-Ridruejo E, Diaz C, Michel MD. Short and long term outcome of kidney transplanted patients with chronic viral hepatitis B and C. Ann Hepatol. 2010;9:271-7
Year 2021, Volume: 54 Issue: 3, 356 - 359, 01.01.2022
https://doi.org/10.20492/aeahtd.810818

Abstract

References

  • 1-Hofmann CJ, Subramanian AK, Cameron AM. Incidence and risk factors for hepatocelluler carcinoma after solid organ transplantation. Transplantation. 2008;86:784-90
  • 2- Forman J, Tolkoff-Rubin N, Pascual M, et al. Hepatitis C, acute humaral rejection and renal allograft survival. J Am Soc Nephrol. 2004;15:3249-55
  • 3-Breitenfeldt MK, Rasenack J, Berthold H. Impact of hepatitis B and C on graft loss and mortality of patients after kidney transplantation. Clin Transplant. 2002;16:130-6
  • 4-Lee WC, Shu KH, Cheng CH. Long-term impact of hepatitis B, Cvirus infection on renal transplantation. Am J Nephrol. 2001; 21:300-6
  • 5-Santos L, Alves R, Macario F. Impact of hepatitis B, Cvirus infection on kidney transplantation: a single center experience. Transplant Proc. 2009;41:880-2
  • 6- Harmancı Ö, İlin S, Öcal S. The Effect of Hepatitis B Virus on Graft and Overall Survival in Kidney Transplant Patients. Exp Clin Transplant. 2015;13:36-40
  • 7- Hyodo N, Nakamura I, Imawari M. Hepatitis B core antigen stimulates ınterleukin-10 secretion by both T cells and monocytes from peripheral blood patients with chronic hepatitis B virus infection. Clin Exp Immunol. 2004;135:462-6
  • 8- Op den Brouw ML, Binda RS, van Roosmalen MH. Hepatitis B virus surface antigen impairs myeloid dendritic cell function: a possible immune escape mechanism of hepatitis B virus. Immunology. 2009;126:280-9
  • 9- Grenha V, Parada B, Ferreira C. Hepatitis B virus, hepatitis C virus, and kidney transplant acute rejection and survival. Transplant Proc. 2015;47:942-5
  • 10- Ridruejo E, Cusumano A, Diaz C. Hepatitis C virus infection and outcome of renal transplantation. Transplant Proc. 2007;39:3127-30
  • 11-Fontaine H, Arlic L, Labreuche J, et al.Control of replication of hepatitis B and C virus improves patient and graft survival in kidney transplantation. J Hepatol. 2019;70:831-8.
  • 12-Meyer CM. Hepatitis C and renal disease: an update. Am J Kidney Dis. 2003;42:631-57
  • 13-Morales JM, Mareen R, Andres A. Renal transplantation in patients with hepatitis C virus antibody. Along national experience. Nephrol Dial Tranplant. 2010;3:41-6
  • 14-Lee J, Cho JH, Lee JS. Pretransplant Hepatitis B Viral Infection Increases Risk of Death After Kidney Transplantation: A Multicenter Cohort Study in Korea. Medicine (Baltimore). 2016;95:e3671.
  • 15-Lai CL, Shoval D, Lok AS. Entecavir versus lamivudine for patients with HBeAg-negative chronic hepatitis B. N Engl J Med. 2006;354:1011-20
  • 16-Marcellin P, Heathcote EJ, Buti M. Tenofovir disoproxil fumarate versus adefovir dipivoxil for chronic hepatitis B. N Engl J Med. 2008;359:2442-55
  • 17-Yap DY, Tang CS, Yung S. Long-term outcome of renal transplant recipients with chronic hepatitis B infection-impact of antiviral treatment. Transplantation. 2010;90:325-30
  • 18-Nkongolo S, Ni Y, Lempp FA. Cyclosporin A inhibitis hepatitis B and hepatitis D virus entry by cyclophilin-independent interference with the NTCP receptor. J Hepatol. 2014;60:723-31
  • 19- Denewar AA, Monem El-Hendy YA, Wafa EW. The Long-Term Effect of Hepatitis C Virus on the Outcome of Live-Donor Kidney Transplant Recipients. A Retrospective Study.Exp Clin Transplant. 2015;13:402-7
  • 20- Carpio R, Pamugas GE, Danguilan R, Que E. Outcomes of Renal Allograft Recipients With Hepatitis C. Transplant Proc. 2016 ;48:836-9
  • 21-Ridruejo E, Diaz C, Michel MD. Short and long term outcome of kidney transplanted patients with chronic viral hepatitis B and C. Ann Hepatol. 2010;9:271-7
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Original research article
Authors

Refika Karaer Büberci 0000-0003-4737-6681

Saime Paydas

Publication Date January 1, 2022
Submission Date December 16, 2020
Published in Issue Year 2021 Volume: 54 Issue: 3

Cite

AMA Karaer Büberci R, Paydas S. Hepatit-B ve C enfeksiyonlarının böbrek transplatasyonunda graft ve karaciğer fonksiyonlarına etkisi: Türkiye’den tek merkez deneyimi. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. January 2022;54(3):356-359. doi:10.20492/aeahtd.810818