Transplantation of livers from HBc Ab positive donors into HBc Ab negative recipients: a strategy and preliminary results

Loss, G. E., Mason, A. L., Blazek, J., Dick, D., Lipscomb, J., Guo, L. S., Perrillo, R. P. and Eason, J. D. (2001). Transplantation of livers from HBc Ab positive donors into HBc Ab negative recipients: a strategy and preliminary results. In: Meeting of the South Eastern Organ Procurement Foundation, Norfolk, VA, United States, (55-58). 14 September 2000. doi:10.1034/j.1399-0012.2001.00010.x

Author Loss, G. E.
Mason, A. L.
Blazek, J.
Dick, D.
Lipscomb, J.
Guo, L. S.
Perrillo, R. P.
Eason, J. D.
Title of paper Transplantation of livers from HBc Ab positive donors into HBc Ab negative recipients: a strategy and preliminary results
Conference name Meeting of the South Eastern Organ Procurement Foundation
Conference location Norfolk, VA, United States
Conference dates 14 September 2000
Journal name Clinical Transplantation   Check publisher's open access policy
Publication Year 2001
Sub-type Fully published paper
DOI 10.1034/j.1399-0012.2001.00010.x
ISSN 0902-0063
Volume 15
Start page 55
End page 58
Total pages 3
Language eng
Abstract/Summary Here we describe a strategy for using livers from hepatitis B core antibody (anti-HBc) positive donors in anti-HBc negative recipients and report our preliminary results. Adult anti-HBc negative recipients were immunized against hepatitis B virus (HBV) prior to transplantation. Liver biopsies from anti-HBc positive, HBs Ag negative donors were performed at the time of procurement to rule out acute hepatitis or chronic liver disease. Donor serum and liver samples were collected for HBV DNA analysis by PCR. Recipients were given HBIG (10 000 units, i.v.) during the anhepatic phase of transplantation. Patients were treated with lamivudine (150 mg) beginning on postoperative day (POD) 1. If HBV DNA was not detected in either donor liver or serum by PCR, recipient antiviral therapy was stopped. If donor liver and serum were positive for HBV DNA by PCR, the recipient was maintained on combination lamivudine and HBIG therapy. If HBV DNA was detected in donor liver but not in donor serum, the patient was managed on lamivudine therapy alone. Between February 1999 and June 2000, six anti-HBc negative recipients received liver transplants from anti-HBc positive donors. PCR analysis of serum from the six donors was negative for HBV DNA in each, while donor liver PCR analysis was positive in five of six for HBV DNA. Accordingly, all patients were given HBIG in the anhepatic phase of transplantation and five of six were maintained on daily lamivudine therapy. Follow-up periods have ranged from 2 to 18 months. There has been no emergence of de novo hepatitis B. Serial serum HBs Ag and HBV DNA assays have all proven negative. Moreover, while on lamivudine therapy, 2 patients now have undetectable HBV DNA in hepatic allograft biopsies by PCR analysis. Our strategy for using livers from anti-HBc donors has yielded promising initial results. De novo hepatitis B has not occurred and our data suggest residual hepatitis B virus may be eradicated in recipients maintained on lamivudine therapy.
Keyword hepatitis B core antibody
liver transplantation
hepatitis B virus
hepatitis B immune globulin
marginal organ donors
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Conference Paper
Collection: School of Medicine Publications
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Created: Mon, 14 Mar 2011, 09:39:57 EST