Tỷ lệ sống của bệnh nhân và chức năng thận ghép ở bệnh nhân nhiễm virus viêm gan C sau ghép thận

Introduction and objectives. Hepatitis C virus (HCV) infection is a challenge for kidney transplantation. HCV positive .transplant patients usually have reduced survival and higher graft loss rate. The objectives of this study were to evaluate the HCV infection rate among kidney transplant patients who have been followed-up regularly in Viet Duc hospital and to assess the patient and graft survival of this population of patients. Patients and Method. Retrospective study conducted on 359 kidney transplant patients who have been followed-up at Viet Duc hospital from February 2005 to May 2013. Time at patients' death, graft loss (restart dialysis) was registered. All patients were on triple immunosuppressive regimen. Serum urea, creatinin and HCV-RNA were tested regularly following routine follow-up protocols. Results. Sixty patients (43 males and 17 females, average age 44.7 + or - 12.5 years old) were HCV positive among a total of 359 patients included (16.7 percent). All HCV positive patients had been on maintenance hemodialysis prior to transplantation. 45/60 (75.0 percent) were infected through hemodialysis. In 15/60 patients (25.0 percent) the route of transmission was unclear. Patient survival and graft survival among HCV positive patients at 2 years, 4 years, 6 years, 8 years and 10 years after transplantation were 95.0 percent and 91.7 percent; 93.2 percent and 84.8 percent; 82.5 percent and 75.0 percent; 78.1 percent and 62.5 percent; 72.0 percent and 48.6 percent respectively. Average serum creatinine after transplantation, year 1, year 3, year 5 was 131.4 + or - 46.6; 135.3 + or - 68.0; 160.9 + or - 72.9; 219.8 + or - 146.1 umol/l respectively. Among 44 patients having regular HCV-RNA testing 38 were positive (86.4 percent). Conclusion. HCV infection rate among kidney transplant patients at Viet Duc hospital was 17.6 percent. Although patient survival following transplantation remained relatively high, kidney function has been reduced significantly after 5 years of being transplanted.