A study on the biochemical and the morphological changes in the liver in renal transplant recipients with an evidence of the HBV and the HCV infections.

CONTEXT: Renal transplantation is the definitive treatment in renal failure patients. Liver disease is a known problem in renal transplant recipients. They may be consequent to immunosuppression, drug toxicity, altered immune response to viruses and hemodialysis.

AIMS: The aim of this study was to analyze and correlate the biochemical parameters and histopathology of liver biopsy among renal transplant recipients with both HBV and HCV infection and to correlate them.

SETTING

The study group had thirty cases. Enrolment criteria included coinfection with HBV and HCV ; elevated liver enzymes and recipient of renal allograft. There was acontrol group of ten patients who were HBC and HCV positive but had not undergone renal transplant.

MATERIAL &

METHODS

Liver function tests including alkaline phosphatase, SGOT, SGPT and serum bilirubin levels were donet. Percutaneous liver biopsies were carried out using Menghini's needle.. Stains done included hematoxylin and eosin (H & E), vanGieson, reticulin and Perl's stain. Histopathological grading was performed using Metavir scoring system. Immunohistochemistry (IHC) was done where required for ground glass hepatocytes. Correlation of SGOT, SGPT and Alkaline phosphatase of the study group and the controls was carried out with the grading.

STATISTICAL ANALYSIS: Statistical tests done included paired "t" test at 5% and test of probability.

RESULTS

There was no statistically significant correlation between the controls and the transplanted patients. It was concluded that serum enzyme levels could be used to predict histological grade in the control group but not in the transplant recipients (p>0.05).