Outcome after kidney transplantation in hepatitis B surface antigen-positive patients

Abstract 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,...

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Autores principales:	Hyejin Mo, Sangil Min, Ahram Han, In Mok Jung, Jongwon Ha
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2ed20fcbe80d46dbb843f50d7c2cfd51
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spelling	oai:doaj.org-article:2ed20fcbe80d46dbb843f50d7c2cfd512021-12-02T18:25:04ZOutcome after kidney transplantation in hepatitis B surface antigen-positive patients10.1038/s41598-021-91331-y2045-2322https://doaj.org/article/2ed20fcbe80d46dbb843f50d7c2cfd512021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91331-yhttps://doaj.org/toc/2045-2322Abstract 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.Hyejin MoSangil MinAhram HanIn Mok JungJongwon HaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hyejin Mo Sangil Min Ahram Han In Mok Jung Jongwon Ha Outcome after kidney transplantation in hepatitis B surface antigen-positive patients
description	Abstract 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	article
author	Hyejin Mo Sangil Min Ahram Han In Mok Jung Jongwon Ha
author_facet	Hyejin Mo Sangil Min Ahram Han In Mok Jung Jongwon Ha
author_sort	Hyejin Mo
title	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_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_sort	outcome after kidney transplantation in hepatitis b surface antigen-positive patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/2ed20fcbe80d46dbb843f50d7c2cfd51
work_keys_str_mv	AT hyejinmo outcomeafterkidneytransplantationinhepatitisbsurfaceantigenpositivepatients AT sangilmin outcomeafterkidneytransplantationinhepatitisbsurfaceantigenpositivepatients AT ahramhan outcomeafterkidneytransplantationinhepatitisbsurfaceantigenpositivepatients AT inmokjung outcomeafterkidneytransplantationinhepatitisbsurfaceantigenpositivepatients AT jongwonha outcomeafterkidneytransplantationinhepatitisbsurfaceantigenpositivepatients
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Outcome after kidney transplantation in hepatitis B surface antigen-positive patients

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