Allografts positive for hepatitis B surface antigen in liver transplant for disease related to hepatitis B virus.

Abstract

OBJECTIVES:

Liver grafts from hepatitis B surface antigen-negative and anti-core antibody-positive donors are safe for liver transplant. However, the use of hepatitis B surface antigen-positive liver donors in liver transplants is controversial. We assessed the safety and effectiveness of liver transplants using hepatitis B surface antigen-positive liver grafts to patients with diseases related to hepatitis B virus.

MATERIALS AND METHODS:

We retrospectively reviewed 23 patients who had a deceased-donor liver transplant using hepatitis B surface antigen-positive liver grafts. All patients had end-stage liver disease secondary to hepatitis B virus infection. Recipients had oral entecavir and intravenous or intramuscular injection of hepatitis B immune globulin for >1 year after the transplant.

RESULTS:

Two patients died from severe perioperative pneumonia, and the other 21 patients were followed for 9 to 38 months after transplant. All 21 patients remained hepatitis B surface antigen-positive. A repeat liver transplant was performed in 1 patient at 5 months after the initial transplant because of biliary ischemia. There were 3 patients who died from recurrent liver cancer at 9, 14, and 18 months after transplant. There were 18 patients (78%) who survived and 17 grafts (74%) that survived.

CONCLUSIONS:

Liver transplant using hepatitis B surface antigen-positive liver grafts is safe for patients with end-stage liver disease secondary to hepatitis B virus infection.

• Authors: Weiqiang Ju, Maogen Chen, Zhiyong Guo, Dongping Wang, Xiaofeng Zhu, Jiefu Huang, Xiaoshun He
• Journal: Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation (Exp Clin Transplant) Vol. 11 Issue 3 Pg. 245-9 (Jun 2013) ISSN: 2146-8427 [Electronic] Turkey
• PMID: 23176583 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• Biomarkers
• Hepatitis B Surface Antigens
• Hepatitis B Vaccines
• Immunosuppressive Agents
• entecavir
• Guanine

Topics

• Administration, Oral
• Adult
• Antiviral Agents (administration & dosage)
• Biomarkers (blood)
• Carcinoma, Hepatocellular (mortality, surgery, virology)
• Donor Selection
• Drug Administration Schedule
• Guanine (administration & dosage, analogs & derivatives)
• Hepatitis B (blood, complications, diagnosis, mortality, surgery)
• Hepatitis B Surface Antigens (blood)
• Hepatitis B Vaccines (administration & dosage)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Injections, Intramuscular
• Injections, Intravenous
• Kaplan-Meier Estimate
• Liver Cirrhosis (mortality, surgery, virology)
• Liver Neoplasms (mortality, surgery, virology)
• Liver Transplantation (adverse effects, mortality)
• Male
• Middle Aged
• Retrospective Studies
• Risk Factors
• Time Factors
• Tissue Donors
• Treatment Outcome