title: Risk of inappropriate exclusion of organ donors by introduction of hepatitis B core antibody testing.
abstract: BACKGROUND
  Hepatitis B virus infection originating from hepatitis B surface antigen-negative, hepatitis B core antibody (anti-HBc)-positive organ donors has been documented, and anti-HBc-positive donors have been excluded as liver donors. We assessed the prevalence of anti-HBc in UK organ donors and followed up recipients of organs from anti-HBc-positive donors for serological evidence of posttransplantation hepatitis B virus infection.
  
  
  METHODS
  Serum samples from 400 hepatitis B surface antigen-negative organ donors were tested for anti-HBc.
  
  
  RESULTS
  Only five (1.25%) of 20 sera in which anti-HBc was initially detected were confirmed as anti-HBc positive on further testing. Posttransplantation serum samples from four recipients of confirmed anti-HBc-positive organs showed no evidence of de novo hepatitis B infection.
  
  
  CONCLUSIONS
  The poor specificity of some anti-HBc immunoassays was confirmed and suggests that donor exclusion on the basis of a single anti-HBc-positive result may result in the inappropriate loss of organs.
authors.affiliation: Department of Medicine, School of Clinical Medicine, University of Cambridge, UK.
authors.forename: D P
authors.initials: DP
authors.lastname: Turner
authors.forename: M
authors.initials: M
authors.lastname: Zuckerman
authors.forename: G J
authors.initials: GJ
authors.lastname: Alexander
authors.forename: J
authors.initials: J
authors.lastname: Waite
authors.forename: T
authors.initials: T
authors.lastname: Wreghitt
mesh_terms: D005189:False Positive Reactions; D006510:Hepatitis B Antibodies / Q000032:analysis* / Q000276:immunology; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006801:Humans; D014019:Tissue Donors
chemical_list: D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens