Liver transplantation in hepatitis B core-negative recipients using livers from hepatitis B core-positive donors: A 13-year experience

Bohorquez, Humberto E., Cohen, Ari J., Girgrah, Nigel, Bruce, David S., Carmody, Ian C., Joshi, Shoba, Reichman, Trevor W., Therapondos, George, Mason, Andrew L. and Loss, George E. (2013) Liver transplantation in hepatitis B core-negative recipients using livers from hepatitis B core-positive donors: A 13-year experience. Liver Transplantation, 19 6: 611-618. doi:10.1002/lt.23644

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Author Bohorquez, Humberto E.
Cohen, Ari J.
Girgrah, Nigel
Bruce, David S.
Carmody, Ian C.
Joshi, Shoba
Reichman, Trevor W.
Therapondos, George
Mason, Andrew L.
Loss, George E.
Title Liver transplantation in hepatitis B core-negative recipients using livers from hepatitis B core-positive donors: A 13-year experience
Journal name Liver Transplantation   Check publisher's open access policy
ISSN 1527-6465
1527-6473
Publication date 2013
Sub-type Article (original research)
DOI 10.1002/lt.23644
Open Access Status
Volume 19
Issue 6
Start page 611
End page 618
Total pages 8
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Collection year 2014
Language eng
Subject 2746 Surgery
2747 Transplantation
2721 Hepatology
Abstract The use of livers from hepatitis B surface antigen-negative (HBsAg -)/hepatitis B core antibody-positive (HBcAb+) donors in liver transplantation (LT) for HBsAg-/HBcAb- recipients is still controversial because of a lack of standard antiviral prophylaxis and long-term follow-up. We present our 13-year experience with the use of HBcAb+ donor livers in HBcAb- recipients. Patients received prophylaxis with hepatitis B immunoglobulin at the time of LT and then lamivudine daily. De novo hepatitis B virus (HBV) was defined as positive HBV DNA detection. Between January 1999 and December 2010, 1013 adult LT procedures were performed at our center. Sixty-four HBsAg-/HBcAb- patients (6.3%) received an HBsAg-/HBcAb+ liver. All donor sera were negative for HBcAb immunoglobulin M and HBV DNA. The mean follow-up was 48.8 ± 40.1 months (range = 1.2-148.8). Both the patient survival rates and the graft survival rates were 92.2% and 69.2% at 1 and 5 years, respectively. No graft losses or deaths were related to de novo HBV. Nine of the 64 patients (14.1%) developed de novo HBV. The mean time from LT to de novo HBV was 21.4 ± 26.1 months (range = 10.8-92.8 months). De novo HBV was successfully treated with adefovir or tenofovir. In conclusion, HBcAb + allografts can be safely used in HBcAb- recipients without increased mortality or graft loss. Lifelong prophylaxis, continuous surveillance, and compliance are imperative for success. Should a de novo infection occur, our experience suggests that a variety of treatments can be employed to salvage the graft and obtain serum HBV DNA clearance. Liver Transpl 19:611-618, 2013. © 2013 AASLD. Copyright
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Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
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