BACKGROUND: A number of studies have reported the renal transplantation in patients with hepatitis B virus infection in China, but few research investigates the liver biopsy in hepatitis B virus infection patients before renal transplantation.
OBJECTIVE: To conduct the liver biopsy in patients with chronic renal failure and different degrees of chronic hepatitis B before kidney transplantation, and to observe the turnovers during 2-year post-transplant follow-up observations.
METHODS: A total of 21 uremic patients with hepatitis B virus infection who are candidates for renal transplantation received liver biopsy. According to pathological changes in liver biopsy, patients were divided into three groups: mild (n = 9), moderate (n = 7), and severe (n = 5). After renal transplantation all patients were followed up for 2 years. There were two cases in each of three groups undergoing repeated liver biopsy for histopathological examination.
RESULTS AND CONCLUSION: All observation indicators showed no significant changes in patients with mild chronic hepatitis B in the 2-year follow-up. In the patients with moderate chronic hepatitis B, the glutamyl transpeptidase activity was significantly higher than normal level from 3 months after transplantation, and two cases were diagnosed as severe disease by repeated liver biopsy at the end of follow-ups. In the patients with severe chronic hepatitis B, the glutamyl transpeptidase activity was higher than normal levels from 3 months after transplantation; the serum albumin was lower than normal levels from 18 months, but the globulin levels were higher than normal; four cases showed cirrhosis changes at the end of follow-ups. The experimental results indicate that, the prognosis alter in patients with different degrees of chronic hepatitis B after renal transplantation, and liver biopsy is an important means to evaluate the lesion degree of liver disease and it can guide the effect of renal transplantation.