Clinical Outcomes of Renal Transplantation in Hepatitis C Virus Positive Recipients

Background: Hepatitis C virus infection confers 1.62-2.39 fold increase in risk of death for hemodialysis patients. The quality of life, morbidity and mortality of chronic kidney disease patients on maintenance hemodialysis is worse when compared to the quality of life, morbidity and mortality of patients undergoing renal transplantation. For these reasons, renal transplantation is better therapeutic option for hepatitis C virus infected patients on maintenance hemodialysis. Aim: To study of clinical outcomes of renal transplantation in hepatitis C virus positive renal transplantation recipients. Materials and methods: Single arm prospective observational study done on 28 hepatitis C virus positive patients who underwent either live related or deceased donor transplantation in our department during 2010 -2013 were followed in our ward and outpatient department. Results: Delayed graft function was present in 11 (39%) patients. Acute cellular rejection was present in 8 patients (26%). New onset of diabetes mellitus after transplant (NODAT)/ Post Transplant Diabetes Mellitus (PTDM) was present in 16 patients (57%). Sepsis occurred in 17 recipients (61%). Cytomegalovirus infection was present in 11 recipients (39%). Invasive fungal infection was present in 7 recipients (25%). Conclusion: The short term patient and graft survival of HCV positive recipients was better. There was high incidence of NODAT in HCV positive recipients, and occurrence of NODAT was within 3 months after transplant. The incidence of sepsis and cytomegalovirus in HCV positive recipients was higher, it is better to keep minimal level of immunosuppression. The incidence of acute rejection, interstitial fibrosis, fungal infection and graft survival in HCV positive recipients was not statistically significant from HCV negative recipients. The short duration of follow up is a main limitation of the study.