Hepatitis Affecting Hemodialysis and Transplant Patients

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Abstract
Thirty-eight cases of hepatitis affecting dialysis and transplant patients, medical personnel, and one patient's spouse were recognized from March 1969 through July 1970. Dialysis patients were usually symptomatic; almost one half were jaundiced, one died of hepatic failure, and persistence of Au antigenemia was not the rule. The immunosuppressed posttransplant patient had a benign clinical course compared with both dialysis patients and contact cases. Azathioprine therapy adversely influenced the course of hepatitis in some posttransplant patients, and its temporary discontinuation was associated with rapid clinical and biochemical recovery and with a change from positive to negative test results for Australia (Au) antigen in two of four patients. Six posttransplant patients had chronic Au antigenemia, but only two of them had chronic elevation of serum glutamic oxaloacetic transaminase values. Three other posttransplant patients have had intermittently elevated transaminase values without a positive Au antigen reaction.