丙型肝炎病毒感染对肾移植术后影响的临床研究

Hepatitis C virus infection and clinical outcome of kidney transplantation

目的探讨丙型肝炎病毒(Hepatitis C virus,HCV)感染对肾移植术后的影响。方法比较86名HCV感染和86名非HCV感染病人肾移植术后1,3,5年人/肾存活率和急、慢性排斥反应的发生率,并对死亡病例的原因进行分析。结果两组病人在肾移植术后不同时间人/肾的存活率分别为:术后1年(94.2%/90.7%和96.8%/96.0%);术后3年(88.4%/79.1%和90.7%/87.2%);术后5年(74.4%/73.3%和87.2%/81.4%)。两组急性排斥反应发生率为31.3%和21.2%,慢性排斥反应发生率为12.5%和6.5%。其中HCV感染组5年人存活率低于非HCV感染组(P<0.05),而其他各项结果无统计学差异(P>0.05)。肝病为感染组的首位死亡原因(36.4%)。结论HCV感染对肾移植受者术后长期存活存在负面影响,HCV感染应作为肾移植手术的相对禁忌证。

Objective To study the influence of hepatitis C virus (HCV) infection on the clinical outcome of kidney transplan- tation. Methods The recipient/graft survival, the incidence of acute/chronic rejection and cause of death in 86 HCV-infected recipients of renal transplantation were compared with those in another 86 recipients without HCV infection. Results HCV-infected recipients had significantly shorter 5-year survival (74.4%) than those without HCV infection (87.2%, P<0.01). The 1-year (94.2%/90.7% vs96.8%/96.0%) and 3-year recipient/graft survival rates (88.4%/79.1% vs90.7%/87.2%), the incidence of acute/chronic rejection (31.3% vs21.2%, and 12.5% vs6.5%) and the 5-year graft survival (73.3%/81.4%) were comparable between the two groups (P>0.05). Hepatic disease was identified as the primary cause of mortality. Conclusions HCV infection may affect the long-term survival of the recipients with kidney transplantation, and therefore should be considered as a relative contraindication of kidney transplantation.