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이식 전 B형 간염 바이러스 감염이 이식 신의 예후에 미치는 영향
김윤구,한진석,김성권,이정상,김상준,김수태 대한내과학회 1990 대한내과학회지 Vol.38 No.1
To evaluate the impact of HBV infection on graft survial following renal transplantation, we studied 161 recipients whose Hepatitis B surface antigen(HBsAg) status was identified before transplantation by actuarial life table method and log-rank analysis. We considered graft loss as patient'’s death, return to maintenance dialysis or removal of graft. 1) Survival in the HBsAg positive group(18 losses among 22 recipients) was significantly diminished(p=0. 0001) compared with the HBsAg negative group(40 of 139 recipients) and the difference was highly significant in recipients with cyclosporine therapy but not in those with azathioprine. 2) In the HBsAg negative group, no obvious differences in survival were found among the groups categorized by the presence of anti-HBs or anti-HBc prior to transplantation. 3) In the HBsAg positive group, those with no mismatch for HLA showed better survial and there were no differences in graft survival compared with the HBsAg negative group. 4) There were 4 deaths from hepatic failure which occurred only in the HBsAg positive group and only in recipients with cyclosporine therapy. We conclude that patients with pre-existing HBs antigenemia may be poor candidates for renal transplantation.