Abstract: Objective This study was conducted to report the 120-week prognosis of serum HBsAg positive patients with chronic renal failure (CRF) after renal transplantation (RT). Methods The clinical data of 69 patients with serum HBsAg positive and CRF were retrieved. The patients were encountered in our hospital between January 2018 and September 2021, and all underwent RT, 26 of whom receiving liver from serum HBsAg positive donors, and followed-up for 196 weeks (with mean of 120 weeks). After RT, all patients took entecavir for antiviral treatment and standardized immunosuppression therapy. Results The incidence of delayed graft function recovery (DGF) occurred in 3 cases(4.4%) after RT in our series, and at the end of follow-up, 67 patients (97.1%) survived; at follow-up 24 week, 48 week, 96 week and 168 week, there were no significant differences as respect to serum ALT, AST and creatinine levels between 26 patients receiving livers from serum HBsAg positive and 43 patients receiving liver from serum HBsAg negative donors, or between 17 recipients with baseline serum HBV DNA positive and 52 recipients with HBV DNA negative (P＞0.05). Conclusion Under the protection of regular antiviral therapy, the recipients with serum HBsAg-positive might survive long-termly with relatively normal liver and renal function tests, even with livers from serum HBsAg-positive donors. The baseline serum HBV DNA loads of the recipients, the donor's serum HBsAg status, and the immunosuppressants administered after RT might not impact the outcomes of recipients in this setting.

Key words: Hepatitis B surface antigen, Renal transplantation, HBsAg positive donors, Entecavir, Prognosis