Long-Term Effect of HbSAntigenemia on Patient Survival after Renal Transplantation

Abstract

We studied 121 renal-graft recipients to delineate the effects of HB_s antigenemia on patient and graft survival. Grafts had functioned for at least six months; follow-up periods averaged 37 months. Mortality was significantly higher (Ps Ag-positive (17 deaths among 61 patients) than in the HB_s Ag-negative group (eight of 60 patients). Patient and graft survivals, from six months onwards, were significantly lower at four years in the positive (64 and 60 per cent respectively) than in the negative group (87 and 80 per cent respectively). These differences resulted solely from a fivefold increase in mortality from liver disease in the positive group and were unrelated to graft rejection. HB_s antigenemia did not improve graft tolerance during the first 24 months in 129 patients in whom repeated HB_s Ag determinations had been obtained before operation. We conclude that HB_s antigenemia has an unfavorable effect on transplant and patient survival. (N Engl J Med 296:194–196, 1977)