Conclusions: HBV/A has been increasing in CHB patients in Japan as the consequence of AHB, spreading in the younger generation through promiscuous sexual contacts, thrust by an inclination of HBV/A to induce chronic hepatitis. The spread of HBV/A infection in Japan should be prevented by universal vaccination programs. Introduction: Chronic viral hepatitis is common in end-stage renal disease (ESRD), from endemic hepatitis B (CHB) and nosocomial hepatitis C (CHC). Reduced outcomes post-renal transplant were reported thus CHB and CHC cirrhosis became contraindications to listing. However, these predated effective anti-viral therapies. We reviewed outcomes of patients with chronic viral hepatitis following assessment for renal transplantation. Methods: Prospective database of ESRD patients with viral hepatitis referred for renal transplantation was reviewed. Results: 110 patients were assessed. 23 patients underwent kidney transplantation. Two were cirrhotic and had liver/kidney transplantation; both died within 6 months. 21 were non-cirrhotics, of whom 20 are alive. 14/20 have functioning allografts; predictors were normal ALT and low viral load. Of the 87 non-transplanted, 31 had cirrhosis; 17/31 received anti-virals. Mortality was 35% -7 liver-related (3 hepatoma,1 bacterial peritonitis,3 sepsis -5 inactive cirrhosis); 4 non-liver related (2 cerebral,1 haemorrhage,1 renal -3 inactive cirrhosis). 12/20 surviving cirrhotics received anti-virals. In non-transplanted non-cirrhotics, mortality was 18%; 80% of survivors had inactive disease. 23 CHB patients received Lamivudine; 11 Adefovir (Lamivudine resistance). 11 CHC patients received IFN-based therapy. Conclusion: Excellent outcomes are achieved in ESRD patients with CHB/CHC post-renal transplant, in absence of cirrhosis. Normal ALT/non-detectable viral load can predict graft function. However, cirrhosis is associated with high mortality on dialysis whereas non-cirrhotics with inactive disease do well. The role of kidney transplantation in cirrhotics with suppressed viral replication needs to be reassessed.