Renal transplantation from HBsAg positive donors to HBsAg negative recipients.

oestrogen therapy and protection from death from ischaemic heart disease. CH. A prospective study of postmenopausal estrogen therapy and coronary heart disease. Regulation of prosta-cyclin and thromboxane production by human umbilical vessels, the effect of estradiol and progesterone in a superfusion model. Prostaglandins Leukotrienes Med 1982;85:115. 31 Dyken ML, Wolf PA, Barnett HJM, et al. Risk factors in stroke: a statement for physicians by the subcommittee on risk factors and stroke of the Stroke related to death from coronary heart disease and stroke. A prospective, controlled trial of six forms of hormone replacernent therapy given to postmenopausal women. Effect of obesity on conversion of plasma androstenedione to estrone in postmeno-pausal women with and without endometrial cancer. Reduction of premature mortality by high physical activity: a 20-year follow up of middle-aged Finnish men. A case-control study of menopausal estrogen therapy and hip fractures. There has recently been a rapid increase in the numbers of people undergoing dialysis in Hong Kong owing to an active programme of continuous ambulatory peritoneal dialysis.' The number of renal transplants performed2 can barely keep up with the numbers of patients accepted for dialysis because of the scarcity of donor kidneys. We describe here our initial experience in transplanting kidneys from donors positive for hepatitis B surface antigen to recipients negative for hepatitis B surface antigen. Patients, methods, and results Four patients who were negative for hepatitis B surface antigen, as assessed by a reversed passive haemagglutination test, received kidneys from donors positive for the antigen (table). They all received azathioprine and prednisolone as immunosuppressive agents. Case I-A 30 year old man received a kidney from his sister. Hyperimmune gammaglobulin was given in a dose of 3 ml immediately before the operation and another dose three months later. Good graft function was achieved. Fifty months after transplantation cyclosporin was substituted for azathioprine because of a slow but steady decline in renal function. The patient remained negative for hepatitis B surface antigen three years after transplantation. Antibodies to hepatitis B surface antigen were detected at two years but persisted for only six months. At the last review the patient's serum creatinine concentration was 276 Fmol/l, and his transaminase activities were normal.