Transplantation of a hepatitis B surface antigen-positive donor liver into a hepatitis B virus-negative recipient.
A critically ill, HBV seronegative girl who received a liver from a HBsAg+ donor is described. Despite HBV Ig prophylaxis, she was seropositive for HBsAg shortly after transplantation. Although the postoperative period was complicated, HBV-related problems were not encountered. Liver dysfunction was noted 7 months after transplantation. At that time, she became anti-HBc IgM-positive, with liver histologic findings suggestive of chronic active hepatitis B. The liver function normalized after a reduction of immunosuppressive therapy and introduction of ciprofloxacin. The patient had low level HBV replication during the entire follow-up period (HBV DNA-positive by PCR only) and sequencing of the virus on 4 occasions revealed only wild-type HBV. She subsequently lost serum HBsAg and HBV DNA (even by PCR) and has remained well 2 years after transplantation.
Department of Medicine, University of Florida, Gainesville 32610.
R P
RP
González-Peralta
J M
JM
Andres
F Y
FY
Tung
J W
JW
Fang
M E
ME
Brunson
G L
GL
Davis
J Y
JY
Lau
D001483:Base Sequence; D002648:Child; D002908:Chronic Disease; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006509:Hepatitis B / Q000635:transmission*; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006515:Hepatitis B virus / Q000502:physiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation / Q000276:immunology*; D008969:Molecular Sequence Data; D014019:Tissue Donors
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D007166:Immunosuppressive Agents