Hepatitis B Antigen Infection and Graft Survival in Cadaveric Renal Transplantation

Hepatitis B and the Dialysis and Renal Transplantation Unit

“…Toussaint et al [20] even suggested that HBs antigenaemia enhanced renal allograft survival. Simi larly, Rashid et al [21] reported better allograft survival in HBsAg-positive patients, as reflected by 13.3% of graft failure in these patients as compared to 32% of graft failure in HBsAg-negative patients at the end of I year. The combined European experience [16] that persistently HBsAg-positive patients reject their grafts less than those who are able to clear the HBsAg from their blood, suggests that in comparing graft survivals between HBsAg-positive and -negative recipients, attempts must be made to distinguish those who are persistently positive from those who are transiently positive, as these patients obviously have different degrees of immunocompétence.…”

“…It is interesting to note that at least two groups of workers have shown that patients with pre-transplant antiHBs antibodies have poor graft survival [21,22], In the series of Rashid et al [21], 6 out of 7 recipients with antiHBs antibodies rejected their grafts in the first year. London et al [22] demonstrated poor graft survival in antiHBs-positive patients, particularly if they received kidneys from male donors.…”

“…However, these inter esting observations have not been confirmed by others [23,24], Evidently, prospective studies involving larger numbers of patients are needed to resolve the problem. While it is tempting to attribute the reported difference in graft survival in patients with different HBsAg and antiHBs status to differences in the immunocompétence of the patients, Rashid et al [21], apart from showing that all their 7 patients with anti-HBs antibodies have one or more preformed antibodies against one or more HLA antigens, have failed to demonstrate any difference in immuno compétence of the lymphocytes between the different groups by in vitro techniques.…”