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Dr. Andrew Rynne

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Can I have renal transplant when I am on medication for HCV infection ?

i am a diabitic type two patient. I am in dyalisys patient from one year and planned to transplant bo the kidneys. at the time of bood testing i found hcv rna positive GNA TYPE 1, even thouhgh i had under gone syngle use dialiazer through the period of dialisys. I had bood trnsfusion once during the month of march 2009. I under took treatment for hcvrna . I took PEgasysy interferon 180mcg treatment . After 8 injections my level of hcv rna become negative. i took further two inejction already. Now gastronics dr. says , i have to take further 12 injections to completely eradicate the hcv rna virus frommy blood . But the nephrologysts is assuring us to go head for kidney transplantation. HOW TO GO HEAD SIR. I AM AGED ABOUR 46 YEARS. kindly suggest the case and oblige thanking you shrinivas
Wed, 25 Jan 2012
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Gastroenterologist 's  Response
Hi Shrenivas
> i am a diabitic type two patient. I am in dyalisys

patient from one year and planned to transplant bo

the kidneys. at the time of bood testing i found hcv

rna positive
-----------------------------------
Dialysis has become a predominant mode of hcv

transmission in world inspite of best dialysis

practices.
--------------------------------------------------

> GNA TYPE 1:
This is difficult to treat genotype and is

associated with poorer outcome.
--------------------------------------------------
>I under took treatment for hcvrna . I took PEgasysy

interferon 180mcg treatment . After 8 injections my

level of hcv rna become negative. i took further two

inejction already. Now gastronics dr. says , i have

to take further 12 injections to completely

eradicate the hcv rna virus frommy blood.

Atleast 48 weeks of treatment is recommended for

genotype 1. Shorter duration is associated with

lower response rate and higher relapse (recurrence).
------------------------------------------
> But the nephrologysts is assuring us to go head

for kidney transplantation.

If you are maintaining a good health on dialysis,

completion of 48 weeks of treatment will be

advisable. But if you are rapidly deteriorating, and

not able to tolerate dialysis, your doctor may

suggest early kidney transplant with following

caveats
     1. HCV may recur
     2. It is not possible to treat HCV

posttransplant
     3. Your liver may suffer rapid damage in

posttransplant period.
     4. You may develop HCV related problems like

cryoglobulinemia

Talk to your nephrologist

DR VAIBHAV BANAIT,
MD, DNB, DM
Consultant gastroenterologist
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