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HBSAg positive recipitant with CKD. KIDNEY TRANSPLANTATION possible?

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My wife suffering from kidney failure ( CKD) & presently she is under dialysis since 3 yrs.we are planning to go for kidney tranpl.donor is my cusion.all test completed

Recipitant is a hbsag positive but viral load below 20 from past 2 yrs

Donor CMV IgG positive & CMV IgM positive,,,,,Receipitant CMV IgG positive & CMV IgM negative.
Receipitant--HCV & HIV--negative
Donor--HCV , HIV & hbsag--negative
can recipitant under go kidney transplatation though donor CMV IgM is positive & any problem in furture

As per my doctor can undergo for transpl by giiving medicines ( tab valcyte 450 mg) to recipitant for 6 months during & after operation.

pl suggest & help me

Category: Nephrologist

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Category: Pediatric Nephrologist
 28 Doctors Online

Thank you for your query at
Donor positivity with CMV can pose a problem to the recipient after the transplant. CMV can lead to several complications including loss of graft ( new kidney). Hence it should be treated aggressively in the form of ' prophylactic therapy'. As such , the donor is unrelated and would be given ' valgancyclovir' sicne the day of transplantation. Valgancyclovir should be given for at least 100 days after transplant and few centers might give it upto 200 days also. Some times , Gancyclovir also would be given. As the transplanation is living related here, you also can treat the donor before hand itself so that the viremia can come down ( Inj Gancyclovir or tablet valcyclovir for 21 days at least before transplantation. The less the viremia the better the prognosis.

Feel free to discuss further,

Patient replied :

we have fix the transplant on 07.11.14 as suggested by per nephrology donor cmv igm is 1.06 which is on broder line , no problem ------whether this is correct
as per nephrology,tab valcyte 450 to be taken by receipitant from 05.11.14 & to continue for 6 months after operation also.
please suggest what to be done at stage which will be helpful for my wife good health.
tab valcyte 450 can be taken by receipitant is ok?? & for donor what to be done at this stage.whether we can postpone by taking medicines as suggest by you sir.
Pl help
--Bhima Raju

No problem. You can go ahead with transplant as I said that she would require valgancyclovir for 200 days after transplant. Usually living transplant with unrelated donor (like cousin),would require the drug even otherwise as they would receive induction ( higher immunosuppressive drugs) therapy at the time of transplantation.
You can plan accordingly and best wishes to you
Let me know if i can ehlp you further,

Patient replied :

thank u doctor for ur valuable suggestion.
My wife suffering CKD from 2005 & under dialysis from past 3 yrs.
i am worried about my wife health & finally arranged amount ,planned for transplant but donor found with CMV IgM positive which put in worry.
It gods gift which has help me in getting suggestion from you doctor & once more heartfull thanks for giving suggestion & motivation.
We required ur blessing to my wife.
---Bhima Raju

Hello Mr.Bhima,
Thank you for your appreciation.
I totally understand what you're going through.
But she will be fine.
Let me know after the transplant.
God bless!!

Patient replied :

good evening doctor
with ur blessing--my wife kidney transplantation completed & she is under medication.
presently Sr cretatine manitaning 1 to 1.2.but
total leucocytes count is 13.86 *1000 --report says WBC mild neutrophilic leukocytosis present--any problem with this
presently tab valgan ,wysolone-15 mg,neroal-100 mg (3 nos per day),azoran , rantac 150 mg ( 2 nos),amtas2.5mg( depending upon BP),vitamin tablets taken as per timming given by doctor.
i planning to meet u sir personally doctor after my wife recovering
please suggest doctor

Admin Message -
Your consult has been closed. Either you have utilized more than 3 follow-up queries or your consult is now older than 1 month. If you have further queries, I request you to initiate a new consult. You could consult the same Doctor as well, please mention the same in the new consult.
Hope this communication was fruitful. Wish you good health.
Thank you
In-house Physician

Dr. Sree Bhushan Raju
Category: Pediatric Nephrologist
FISN : Fellowship of Indian Society of Nephrology(ISN), 2012
FIACM : Fellowship of Indian Association of Clinical Medicin(IACM), 2012
FICP: Indian College of Physicians Association of Physicians of India, 2012
Fellowship: DM, DNB, All India Institute of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, Nizam's Institute of Medical Sciences, 1998
Medical School: MBBS, Gandhi Medical College, 1994
Dr. Sree Bhushan Raju and 4 other Medical Specialists are ready to help you

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