Clinical observation of hepatitis B virus carriers after renal transplantation / 器官移植

ABSTRACT

Objective To observe the changes of liver and kidney function in hepatitis B virus(HBV)carriers after renal transplantation. Methods A total of 116 patients with HBV infection undergoing renal transplantation and 348 counterparts without HBV infection were recruited in this clinical trial. The liver function parameters including alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels and renal function parameter including serum creatinine(Scr)level were measured before and at 1, 3, 6, 12, 18, 24, 36 and 60 months after renal transplantation. Preoperative and postoperative changes of liver and kidney function were statistical y compared between the hepatitis B surface antigen(HBsAg)(+)and HBsAg(–)groups. According to the results of preoperative HBV serology, preoperative quantitative detection of HBV DNA and preoperative liver function test, 116 HBsAg(+)patients undergoing renal transplantation were divided into(HBsAg, HBeAg and anti-HBc all positive)and(HBsAg, anti-HBe and anti-HBc all positive)groups, HBV DNA(+)and HBV DNA(–)groups, and normal and abnormal liver function groups.Preoperativeandpostoperativechangesofliverandkidneyfunctionwerestatisticalycomparedbetweendifferentsubgroups. Results(1)Preoperative ALT and AST levels in HBsAg(+)patients were significantly higher compared with those in their HBsAg(–)counterparts. In 36 months after renal transplantation, liver function parameters significantly differed between two groups(al P<0.05), whereas no statistical significance was noted at postoperative 60 months(al P>0.05). Before and in 60 months after renal transplantation, no statistical significance was observed in the Scr levels between the HBsAg(+)and HBsAg(–)groups(all P>0.05).(2)Before and in 60 months after renal transplantation, no statistical significance was observed in the liver and kidney function parameters between the(HBsAg, HBeAg and anti-HBc all positive)and(HBsAg, anti-HBe and anti-HBc all positive)groups, and HBV DNA(+)and HBV DNA(–)groups(all P>0.05).(3)The ALT levels before and at 1, 3, 6 and 12 months after renal transplantation significantly differed between the normal and abnormal liver function groups(al P<0.05), whereas no statistical significance was observed at other time points(all P>0.05). The AST levels before and at 1 month after renal transplantation significantly differed between two groups(both P<0.05), whereas did not significantly differ at alternative postoperative time points(all P>0.05). No statisticalsignificancewasobservedinthekidneyfunctionparametersbeforeandat60monthsfolowingrenaltransplantation between two groups(al P>0.05). Conclusions HBV infection cannot exert significant effect upon kidney function within 5 years after renal transplantation, whereas it can affect short-term postoperative liver function.