Use of aortic valve allografts from hepatitis B surface antigen-positive donors.
Over a 28-month period, 31 patients undergoing aortic valve replacement received valve allografts from hepatitis B surface antigen-positive, hepatitis B e antigen-negative donors. At the time of operation, 22 recipients were immune to hepatitis B infection; 19 had antibodies to hepatitis B surface antigen, and 3 were hepatitis B surface antigen positive. Nine patients were regarded as being susceptible to hepatitis B; 7 lacked hepatitis B markers, and records of serological status could not be found for the other 2. Four of the susceptible patients received hepatitis B immunoglobulin postoperatively, and 1 of them also received one 10-micrograms dose of hepatitis B vaccine. The 9 susceptible patients underwent hepatitis B serological studies a mean of 17 months (range, 4 to 31 months) postoperatively. In only 1 patient, tested 29 months after operation, had antibodies to hepatitis B surface, hepatitis B core, and hepatitis B e antigens developed. He had not experienced a clinical episode of hepatitis, and results of liver function tests were normal. He had not received prophylaxis. Because hepatitis B virus may be transmitted by hepatitis B surface antigen-positive, hepatitis B e antigen-negative valves, prophylaxis should be given whenever they are used and follow-up serological studies undertaken.
Morris
A
A
Microbiology Department, Green Lane Hospital, Auckland, New Zealand.
Strickett
M G
MG
Barratt-Boyes
B G
BG
D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000637:transplantation*; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006513:Hepatitis B e Antigens / Q000032:analysis; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012698:Serologic Tests; D014019:Tissue Donors
D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens