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Outcome after kidney transplantation in hepatitis B surface antigen-positive patients
Few reports detail the actual outcome of Hepatitis B Surface Antigen-positive patients after kidney transplant. HBsAg-positive patients who underwent kidney transplant between January, 1999, and December, 2018, were reviewed retrospectively. Outcomes including hepatitis B reactivation rate, risk fac...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8175441/ https://www.ncbi.nlm.nih.gov/pubmed/34083686 http://dx.doi.org/10.1038/s41598-021-91331-y |
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author | Mo, Hyejin Min, Sangil Han, Ahram Jung, In Mok Ha, Jongwon |
author_facet | Mo, Hyejin Min, Sangil Han, Ahram Jung, In Mok Ha, Jongwon |
author_sort | Mo, Hyejin |
collection | PubMed |
description | Few reports detail the actual outcome of Hepatitis B Surface Antigen-positive patients after kidney transplant. HBsAg-positive patients who underwent kidney transplant between January, 1999, and December, 2018, were reviewed retrospectively. Outcomes including hepatitis B reactivation rate, risk factors for reactivation, and patient and graft survival rates were analyzed. Seventy-seven patients were enrolled (47.1 ± 11.5 years old). Patients received ABO-incompatible (n = 5), crossmatch positive transplant (n = 2), and re-transplant (n = 4). Forty-six patients received prophylactic; 19, medication at least 3 months before the transplant; and 12, did not receive medication. Seventeen out of 76 patients developed reactivation post-transplant. 52.9% of HBV reactivation was accompanied by hepatitis. Inappropriate, other than lifelong prophylactic, antiviral agents (HR = 7.34, 95% CI 1.51–35.69, P = 0.01) and high hepatitis DNA (≥ 1000 IU/ml) pre-transplant (HR = 4.39, 95% CI 1.08–17.81, P = 0.04) increased reactivation risk. There was no significant difference in patient and graft survival between antigen positive patients who received antiviral agent and propensity score matched negative patients. HBsAg positivity in kidney transplant recipients is associated with substantial HBV reactivation rate. Lifelong antiviral therapy is mandatory, and patients with high preop HBV titer should be monitored closely for HBV reactivation. |
format | Online Article Text |
id | pubmed-8175441 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-81754412021-06-04 Outcome after kidney transplantation in hepatitis B surface antigen-positive patients Mo, Hyejin Min, Sangil Han, Ahram Jung, In Mok Ha, Jongwon Sci Rep Article Few reports detail the actual outcome of Hepatitis B Surface Antigen-positive patients after kidney transplant. HBsAg-positive patients who underwent kidney transplant between January, 1999, and December, 2018, were reviewed retrospectively. Outcomes including hepatitis B reactivation rate, risk factors for reactivation, and patient and graft survival rates were analyzed. Seventy-seven patients were enrolled (47.1 ± 11.5 years old). Patients received ABO-incompatible (n = 5), crossmatch positive transplant (n = 2), and re-transplant (n = 4). Forty-six patients received prophylactic; 19, medication at least 3 months before the transplant; and 12, did not receive medication. Seventeen out of 76 patients developed reactivation post-transplant. 52.9% of HBV reactivation was accompanied by hepatitis. Inappropriate, other than lifelong prophylactic, antiviral agents (HR = 7.34, 95% CI 1.51–35.69, P = 0.01) and high hepatitis DNA (≥ 1000 IU/ml) pre-transplant (HR = 4.39, 95% CI 1.08–17.81, P = 0.04) increased reactivation risk. There was no significant difference in patient and graft survival between antigen positive patients who received antiviral agent and propensity score matched negative patients. HBsAg positivity in kidney transplant recipients is associated with substantial HBV reactivation rate. Lifelong antiviral therapy is mandatory, and patients with high preop HBV titer should be monitored closely for HBV reactivation. Nature Publishing Group UK 2021-06-03 /pmc/articles/PMC8175441/ /pubmed/34083686 http://dx.doi.org/10.1038/s41598-021-91331-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Mo, Hyejin Min, Sangil Han, Ahram Jung, In Mok Ha, Jongwon Outcome after kidney transplantation in hepatitis B surface antigen-positive patients |
title | Outcome after kidney transplantation in hepatitis B surface antigen-positive patients |
title_full | Outcome after kidney transplantation in hepatitis B surface antigen-positive patients |
title_fullStr | Outcome after kidney transplantation in hepatitis B surface antigen-positive patients |
title_full_unstemmed | Outcome after kidney transplantation in hepatitis B surface antigen-positive patients |
title_short | Outcome after kidney transplantation in hepatitis B surface antigen-positive patients |
title_sort | outcome after kidney transplantation in hepatitis b surface antigen-positive patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8175441/ https://www.ncbi.nlm.nih.gov/pubmed/34083686 http://dx.doi.org/10.1038/s41598-021-91331-y |
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