Factors affecting mortality and morbidity in kidney transplant patients with chronic hcv infection

FACTORS AFFECTING MORTALITY AND MORBIDITY IN KIDNEY TRANSPLANT PATIENTS WITH CHRONIC HCV INFECTION HCV and end-stage renal failure are major health problems worldwide. The prevalence of anti-HCV seropositivity in patients on hemodialysis is between 10 %and 49 %. The prevalence of HCV infection in renal transplanted recipients is also high (11%-49%). Chronic HCV infection in hemodialysis patients and kidney transplant recipients is associated with an increased mortality and morbidity due to liver disease. In our study; an overall of 83 anti-HCV positive patients with renal transplantation, who admitted to Baskent University hospital in Ankara between 1982 and 2013, were included. All demographic data and laboratory test results of patients were obtained from their files. In this study, we planned to show the impact of chronic HCV infection on graft and patient survival. Data of the two groups were divided into two groups as the ones who received interferon (INF) treatment, and the ones who did not receive INF treatment. Patient group, who received IFN treatment, compared with the patient group, who did not, graft survival is determined as meaningfully short (0.003). When we studied the other data, which might shorten the graft survival, it is determined that average dialysis period of our patient group, who received IFN treatment, is longer (0.001). DM development, one of the other reasons, which might affect graft survival, did not determined more frequent on the patient group, who received INF treatment. Furthermore, mean age of our patient group, who received IFN treatment, was younger (0.01). An overall of 30 patients were administered INF treatment. Sustained viral response (SVR ) rate was determined as 50 %. Relapse is determined in one patient, from whom SVR was obtained, after kidney transplantation. When we consider the factors, which might affect the patient survival, we determined that mortality of the patients with high viral replication was higher (P: 0,008). Besides, death risk due to sepsis on the patients with high viral burden was found meaningfully high (P < 0,05). When we compared the group with DM diagnosis with the group without DM diagnosis, no meaningful mortality increase was determined (P: 0,589). Post kidney transplantation methylprednisolone treatment and iron accumulation in liver were determined as risk factor for DM development (P = 0,006, P: 0,019). As a result, we think stating that anti-viral treatment can be started on dialysis patients but treatment should be concluded within a short period of time, treatment should be ended in case of maintaining an appropriate donor and dialysis patients should be added to the kidney transplantation lists without considering the HCV infections. Keywords: HCV, Renal transplantation, IFN treatment