Renal disease in hepatitis C-positive liver transplant recipients

Elizabeth A. Kendrick, John McVicar, Kris V. Kowdley, Mary P. Bronner, Mary J. Emond, Charles E. Alpers, David R. Gretch, Robert L. Carithers, James D. Perkins, Connie L. Davis

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

Glomerular abnormalities are frequent in patients undergoing liver transplantation; however, renal dysfunction following transplantation is mainly attributed to cyclosporine toxicity. Membranoproliferative glomerulonephritis (MPGN) is seen in patients infected with hepatitis C virus (HCV), the virus responsible for 30% of the end-stage liver disease leading to liver transplantation. To determine the incidence of renal abnormalities in liver transplant recipients and the association with HCV, we undertook a longitudinal study in HCV-positive (n=91) and HCV-negative (n=106) liver transplant recipients. Mean creatinine clearance before transplantation was 94 ml/min/1.73 m2 in HCV+ patients and 88 ml/min/l.73 m2 in HCV-patients. By 3 months after transplantation, the mean creatinine clearance decreased by approximately one third in both groups. A greater proportion of HCV+ patients excreted >2 g protein/day after transplantation (P=0.05) and had renal biopsies showing MPGN than did HCV- recipients (4/10 HCV+ patients vs. 0/7 HCV- patients; P=0.1). In the HCV+ group, proteinuria was not associated with recurrent HCV hepatitis, DQ matching, posttransplant diabetes, or hypertension. Treatment of HCV-related MPGN with interferon-α2b appeared to stabilize proteinuria and renal function but did not reverse renal dysfunction nor cause liver allograft rejection. After transplantation, HCV+ patients had similar renal function over 3 years after transplantation, compared with HCV- patients, but they had an increased risk of proteinuria and occurrence of MPGN that was only partially responsive to interferon.

Original languageEnglish (US)
Pages (from-to)1287-1293
Number of pages7
JournalTransplantation
Volume63
Issue number9
DOIs
StatePublished - May 15 1997
Externally publishedYes

ASJC Scopus subject areas

  • Transplantation
  • Immunology

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    Kendrick, E. A., McVicar, J., Kowdley, K. V., Bronner, M. P., Emond, M. J., Alpers, C. E., Gretch, D. R., Carithers, R. L., Perkins, J. D., & Davis, C. L. (1997). Renal disease in hepatitis C-positive liver transplant recipients. Transplantation, 63(9), 1287-1293. https://doi.org/10.1097/00007890-199705150-00016