hep c after renal transplant

hi
i am ritesh gangwal, undergoan renal transplant on 27-03-2006. after six successfull months of transplant we came to know that i am infected with hep c virus. my tx kidney is working welll but the problem is with hep c and its creating problem in liver. sgpt and sgot level were more than 250 and serum bilirubin is more than 4. sonography suggesting liver size to be increased and became 15.2 and spleen is midly enlarged. is there any treatment you have which could solve our hep c without disturbing tx kidney. kindly suggest us what to do.
thanking you
ritesh gangwal

[Bill1954]

Hi Ritesh--

I

[sallyo]

I also am NOT a medical expert or physician.  I have however been transplanted (liver) and received treatment for hep C so I know that antirejection meds and hep c treatment can both be done at the same time.  Might depend on which antirejection meds you are on.  I am on Prograf.  Don't know about cell-cept or others.
    I have been told that the prograf is nephrotoxic.  I also deal with a transplant facility that is well experienced with both liver and renal transplants.  I would suggest that you do something like that.  Your kidney transplant neprologist should be able to help.
    Ironic it seems that you are a kidney recipient concerned about your liver and I am a liver recipient concerned about my kidney.
    I am happy that your new kidney is fairing so well and understand your concerns about how the  hcv meds will affect it.
Please seek medical advise soon as I am pretty sure this is NOT unheard of.  Let us know

[mikesimon]

From the little I have read it appears that transplanted kidneys are not as resistant to rejection as are liver allografts and thus rejection is a more serious concern when treating hepatitis c in renal transplant patients. And, as you said, Prograf is nephrotoxic so the available choices for immunosuppression may be different too - I seem to recall that sirolimus was one agent that was touted for renal transplants.
Mike

[mikesimon]

<A HREF="http://www.medscape.com/viewarticle/547086/">Anti-viral Therapy of Hepatitis C Virus-Related Liver Disease in Renal Transplant Patients</A>

From the article:

"In conclusion, this meta-analysis shows that safety and efficacy of IFN-based therapy after RT are poor. The potential benefits of IFN therapy after RT need to be weighed against the risk of allograft rejection in RT recipients. Safer and more effective approaches are required to treat RT patients with HCV."

The link I posted is to medscape.com. To read the article you must be registered at medscape. Registration is free and easy.

Mike

[patty8522]

I had a kidney transplant in 2004. The kidney is doing fine and am blessed with the donors family keeping in touch with me, But, about 4 months after the transplant my liver enzymes were way off the chart with a viral load of 77,000,000. I was hep c neg before surgery and then hep c pos. after the the surgery and the surgeon tried to hide this from me for over a year and convince me I could have had it before. My hospital lab results proved this even tho he tried to deny it was not done and not protocol before surgery (which I now know is false) I am pursuing the answers to my questions and still have not gotten info regarding the procurement protocol. Anyways, in the meantime,I have been to a liver specialist and he said he couldn't treat the geno type1a virus because it would kill the kidney.On my recent abd. u/s my liver looked o.k. but my Dr. said the spleen showed some thickening (11).I'm very thankful for the gift of life and am in touch with my donor's family (her 19yr.old son died) but, I am very bitter how the procurement handled things and get away with being a secretive world, while patients family members are dying and they are donating fir a good thing and UNOS a billion dollar a year business is NOT handling kidneys or other body parts carefully and with the safety of pt's in mind. They have to be honest if they are dealing with an ECD kidney because it can still be a good thing but, not allowed to be a decision that they make. Patty