Median-long term clinical analysis 96 kidney transplant from hepatitis B surface antigen positive donors to hepatitis B antigen positive recipients / 中华器官移植杂志

ABSTRACT

Objective To investigate the safety and efficacy of hepatitis B surface antigen (HBsAg) positivity of the donors on graft survival and liver complications in HBsAg (+) renal transplant recipients.Methods We retrospectively evaluated 96 HBsAg (+) patients who received HBsAg(+) donor kidney transplant fellow-up during 20～ 139 months,in order to observe the renal allograft dysfunction,liver dysfunction and others complications.Results All 96 patients underwent renal transplantation successfully in our hospital.during the follow-up period,18 cases accepted entecavir-treated,one case lost graft function,two cases died,one of them developed drug resistance and liver function failure,the other because of cancer of the liver.Twenty-three of the 78 lamivudinetreated patients (29.5％) developed drug resistance in 7～96 months,and 3 cases developed liver function failure,2 cases died and one cured,15 of the 19 cases who been salvage treated with entecavir was successful and well tolerated after 1 year,2 cases who been salvage treated with adefovir and lamivudine with HBV DNA-negative after 12 months and 23 months.The 5-year patient/graft rates of patients who been treated with lamivudine and entecavir were 88.5％/84.6％ and 88.9％/83.3％ respectively.Conclusion It is safe and feasible for renal transplantation from HBsAg(+) donors to HBsAg(+) recipients with antiviral treatment,patients would require lifelong anti-viral suppression and strictly follow-up,which is important for patient and graft survival,anti-viral drugs resistance and the liver complications should be closely monitored and treated.