The impact of renal transplantation on the course of XXXX .

@entity1 @entity82 @entity1956 @entity409 @entity177 @entity1578 @entity281 @entity292 @entity3619 @entity157 @entity99 @entity360 @entity454
To establish the impact of transplantation on the course of chronic @entity409 we performed a prospective study of the clinical and pathological sequelae of @entity1956 in all 22 @entity1 who had renal allografts that functioned for more than 1 year and who were @entity99 B surface antigen (HBsAg)-positive following transplantation. No @entity1 converted to HBsAg-negative. During a mean follow-up of 83 months serial liver biopsies were performed in 20 @entity1 and 1 liver biopsy was available in the remaining 2 @entity1 . Eleven @entity1 died of @entity409 , 5 of whom died of @entity1578 , 3 with @entity157 , 2 of @entity360 , and 1 of ascites with @entity292 . @entity409 was observed in the vast majority of @entity1 : 12 ultimately developed @entity82 , (mean follow-up 81 months), 6 @entity3619 (mean follow-up 93 months), 3 chronic persistent @entity99 (mean follow-up 89 months), and in 1 @entity1 the presence of HB virus in hepatocytes was the sole morphologic alteration (follow-up 42 months). There was a marked tendency to progression in that 82% of @entity1 with virus only, reactive @entity99 , or chronic persistent @entity99 on initial biopsy subsequently developed @entity3619 or @entity82 . For comparison, 10 HBsAg-positive @entity1 whose @entity177 had been treated by hemodialysis were also studied over a comparable period. Four @entity1 converted to the negative state. Biochemical evidence of persistent @entity409 occurred in only 1 @entity1 and no @entity1 has died from complications of @entity409 . We conclude that in the immunosuppressed renal transplant @entity1 @entity281 often results in the development of @entity82 , leading to death from @entity157 and @entity1578 . This course is worse than that in dialysis @entity1 . Renal transplantation of HBsAg-positive @entity1 with @entity454 may be inadvisable.
