Hepatitis C in Renal Disease, Hemodialysis and Transplantation
This flow traces the conflict between preventing rejection and limiting HCV replication and liver injury.
increasingBearing strength in each eventdecreasing
Necessary Suppression
Necessary Suppression
Protecting the graft
Immunosuppression is indispensable after transplantation because unchecked alloimmunity can destroy the kidney. Yet the same reduction in immune surveillance may permit HCV replication.
A structural contradiction
The transplant succeeds only through a treatment that can worsen the infection. No regimen removes this contradiction; each merely changes its balance.
Drug Comparison
Drug Comparison
Steroid Rescue
Steroid Rescue
Rejection demands escalation
Acute rejection may require high-dose steroid pulses, increasing immunosuppressive pressure precisely when HCV control is already fragile. Viral replication and liver injury can intensify afterward.
No easy reversal
Rapid steroid withdrawal may reduce metabolic toxicity but can create other risks. The conflict persists as a cycle in which treating one threat exposes the patient to another.
