Chronic liver diseases, especially due to chronic hepatitis B virus infection, are among the leading causes of late mortality in renal transplant recipients. We report on 4 HBsAg-positive patients observed over a period of 8 years, who were free of symptomatic liver disease for 7-19 years after renal transplantation and died within a few days of acute hepatic failure. The cases presented document the prognostic relevance of chronic hepatitis B virus infection in renal transplant recipients and illustrate that an asymptomatic HBsAg carrier state can evolve within a very short time to fatal liver disease.
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