Sujit, S (2014) Clinical outcomes of Renal Transplantation in Hepatitis C virus positive recipients. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION : Hepatitis C virus(HCV) infects 20-50% of chronic kidney disease patients(47). The number of chronic kidney disease patients is on increasing trend . The number of chronic kidney disease patients undergoing dialysis is also increasing. Various studies have shown that 3.4-43% of chronic kidney disease patients undergoing maintenance hemodialysis test positive for anti HCV antibodies. Hepatitis C virus infection confers 1.62-2.39 fold increase in risk of death for hemodialysis patients. Various studies have shown that 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. Anti viral therapy for hepatitis C virus should be given before transplantation. The recommendation is to screen for hepatitis C virus infected patients on transplant programme by testing antibodies for hepatitis C virus. If antibodies to hepatitis C virus is detected, we should proceed testing hepatitis C virus RNA . If hepatitis C Virus RNA is detected, genotyping should be done. Based on the genotype , interferon should be given before transplant. Patients attaining sustained viral response after interferon therapy should be taken for renal transplant, after ruling out clinical and biochemical evidence of liver cirrhosis. AIMS AND OBJECTIVES : To study of clinical outcomes of renal transplantation in hepatitis C virus positive renal transplantation recipients . To assessing the all cause mortality among hepatitis c virus positive recipients. 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 immunosupression. 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.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Clinical outcomes ; renal transplantation ; hepatitis C virus ; positive recipients. |
| Subjects: | MEDICAL > Nephrology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 11 Jul 2017 05:52 |
| Last Modified: | 11 Jul 2017 05:52 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1383 |
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