HBs Antigenemia in Renal Allograft Recipients

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Abstract
Of 98 renal allograft recipients with functioning grafts for 6-108 mo., 85 of whom were followed from the initiation of dialysis, 26 (27%) had HBs [hepatitis B surface] antigenemia following transplantation. Of the 26 recipients, 13 (50%) were HbsAg[antigen] positive during dialysis and 13 developed HBs antigenemia 1-44 mo. after transplantation. Of the 26 HbsAg positive patients, 17 (65%) had hepatic dysfunction which was detected by biochemical surveillance and not associated with clinical symptomatology. There was no evidence of progressive hepatic insufficiency. HBsAg persisted in 24 (92%) recipients for 6-49 mo. Clearing of antigenemia occurred in only 2 patients, both of whom ultimately rejected their grafts. The presence of HBsAg had no adverse effect on graft function. Temporary reduction in azathioprine dosage with hepatic dysfunction was not associated with rejection episodes. The major hazard posed by the HbsAg positive recipient is the potential reservoir for spread to the general population because of the persistence of antigenemia.