Prognostic Significance of Hepatitis B Antigenemia in Kidney Transplantation

Toussaint, C; Thiry, Lise; Kinnaert, Paul; Clinet, G.; Vereerstraeten, Pierre; Geertruyden, Jean Van

doi:10.1159/000180739

Cited by 20 publications

(6 citation statements)

References 11 publications

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“…Although we have no explanation, good graft functioning has been described in chronic car riers of other antigens, such as hepatitis HB antigen [3,15,26], The possibility of an IgE basophil sensitization against DNA antigen as seen in patients with systemic lupus erythe matosus [6] needs to be evaluated. In this sense we have recently demonstrated that the majority of transplanted patients present a high number of IgE molecules on the basophil surface due to sensitization against HLA and probably other antigens [7], The percentages of patients developing anti-DNA anti bodies range from 15% with the ammonium sulphate pre cipitation technique, to 23% with the Millipore filtration technique, as explained by the different sizes of the immune complexes discriminated by the two techniques.…”

Section: Discussionmentioning

confidence: 87%

DNA Release and Appearance of Antinuclear Antibodies in Chronic Hemodialysis Patients

Egido

Sánchez-Crespo

Picazo³

et al. 1982

Nephron

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The presence of free serum DNA and/or antibodies against nuclear antigens was studied in 65 patients in chronic hemodialysis. Most of patients showed increased levels of both free single-stranded DNA (ss DNA) (28 out of 29) and native (double-stranded) DNA (n DNA) (25 out of 28) at the beginning of each dialysis session (69 ± 26 vs. 119 ± 15, p < 0.05) suggesting a rapid in vivo degradation of the n DNA released. 15 out of 65 patients (23%) developed low anti-ss DNA antibody titers by Millipore filtration assay. 2 of them presented anti-n DNA antibodies simultaneously. Isolated anti-n DNA, anti-Sm and anti-RNP antibodies were systematically negative in all patients. No relationship was found between the presence of anti-ss DNA antibodies and the type of nephropathy, the duration of treatment and the method of dialysis. The fate of a renal allograft was studied in 12 patients after having measured serum-free DNA and anti-DNA antibodies. The 4 patients with good graft function after 2 years of transplantation had significantly higher circulating ss-DNA levels than the other 8 patients whose grafts were rejected.

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Section: Discussionmentioning

confidence: 87%

DNA Release and Appearance of Antinuclear Antibodies in Chronic Hemodialysis Patients

Egido

Sánchez-Crespo

Picazo³

et al. 1982

Nephron

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“…Since the percentage of hepatitis B infection and the number of chronic carriers were low it was impossible to establish a correlation between the HBs infection and the graft survival. Nevertheless previous observations made in the same hospital suggested that the HBs carriers had a better graft survival than the patients without HBs antigen (18). Eighteen percent of the patients had antiHBs antibodies before the transplantation but the presence of these antibodies seemed to have no influence on the graft rejection or graft survival, Table 2 summarizes the seroconversion rate or significant antibody rises for the other viruses studied.…”

Section: Hepatitis B In/ectionsmentioning

confidence: 87%

Cytomegalovirus infection and graft survival in renal graft recipients

Cappel¹,

Hestermans²,

Toussaint

et al. 1978

Archives of Virology

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We have studied 85 patients who received a renal transplant for CMV infection as well as for herpes simplex (HSV), herpes zoster (HZ), measles, mumps, rubella and hepatitis B. We found no evidence of primary or secondary infections for the non herpetic viruses except for hepatitis B infection that occurred in 17 per cent of the patients. CMV infection occurred in 87 per cent of the patients while antibody rises to HZ and HSV occurred in 30 and 13 per cent of the patients, respectively. The CMV infections occurred 2 to 4 months after the transplantation (mean time 11.1 weeks) and seemed to trigger the first episode of renal rejection that occurred earlier in the CMV infected group (mean time 12.1 weeks) than in the uninfected group (mean time 18.6 weeks). This difference in time is highly significant, p less than 0.001). However these CMV injections did not decrease the longterm survival of the grafted kidneys.

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“…The question remains as to whether chronic active hepatitis affects graft function. A markedly better cumulative 1-and 2-year graft survival was found in chronic HBsAG carriers [21,22], Toussaint et al [21] suggested that the same mechanism might be responsible for both graft tolerance and for persisting HBsAG carrier state. The find ings of Toussaint et al [21], although, could not be con firmed by the 1977 EDTA analysis [23].…”

Section: Discussionmentioning

confidence: 99%

Withdrawal of Azathioprine in Renal Transplant Patients with Chronic Active Hepatitis: Is It Wise or Not?

Loertscher¹,

Brunner²,

Harder³

et al. 1983

Nephron

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Withdrawal of azathioprine in renal transplant recipients with chronic active hepatitis and persisting HBs antigenemia was recommended for its beneficial effect on the course of liver disease. We report here three cases in which azathioprine treatment was stopped for this reason. One of these patients lost his graft due to irreversible vascular rejection 6 years after successful transplantation. Decrease of graft function paralleled azathioprine withdrawal in a second patient. Data from other reports indicate that cessation of azathioprine treatment may be followed by decreased graft function or even graft loss. We conclude that the risk of altered graft function is substantial and this is too high a price to pay for a procedure that may not prevent chronic active hepatitis from progressing to cirrhosis.

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Prognostic Significance of Hepatitis B Antigenemia in Kidney Transplantation

Cited by 20 publications

References 11 publications

DNA Release and Appearance of Antinuclear Antibodies in Chronic Hemodialysis Patients

DNA Release and Appearance of Antinuclear Antibodies in Chronic Hemodialysis Patients

Cytomegalovirus infection and graft survival in renal graft recipients

Withdrawal of Azathioprine in Renal Transplant Patients with Chronic Active Hepatitis: Is It Wise or Not?

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