Table of Contents Author Guidelines Submit a Manuscript
International Journal of Nephrology
Volume 2011, Article ID 245823, 10 pages
http://dx.doi.org/10.4061/2011/245823
Review Article

Management of the Kidney Transplant Patient with Chronic Hepatitis C Infection

1Section of Nephrology, Department of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
2Section of Hepatology, Department of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA
3Division of Transplant Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA

Received 2 December 2010; Accepted 25 January 2011

Academic Editor: James E. Springate

Copyright © 2011 Ignatius Y. S. Tang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Chronic Hepatitis C (HCV) infection is an important cause of morbidity and mortality in patients with end-stage renal disease. Renal transplantation confers a survival advantage in HCV-infected patients. Renal transplant candidates with serologic evidence of HCV infection should undergo a liver biopsy to assess for fibrosis and cirrhosis. Patients with Metavir fibrosis score ≤3 and compensated cirrhosis should be evaluated for interferon-based therapy. Achievement of sustained virological response (SVR) may reduce the risks for both posttransplantation hepatic and extrahepatic complications such as de novo or recurrent glomerulonephritis associated with HCV. Patients who cannot achieve SVR and have no live kidney donor may be considered for HCV-positive kidneys. Interferon should be avoided after kidney transplant except for treatment of life-threatening liver injury, such as fibrosing cholestatic hepatitis. Early detection, prevention, and treatment of complications due to chronic HCV infection may improve the outcomes of kidney transplant recipients with chronic HCV infection.