Infectivity of hepatic allografts with antibodies to hepatitis B virus.
BACKGROUND
Since suitable recipients for hepatic allografts from donors with antibodies to hepatitis B virus (HBV) have not been determined, a review of our 7-year experience with donors positive for hepatitis B surface antibody (anti-HBs), hepatitis B core antibody (anti-HBc), or both was undertaken.


METHODS
Recipients of hepatic allografts from donors with antibodies to HBV were identified by a retrospective review of procurement records and screened for HBV infection.


RESULTS
From January 1, 1990, to January 1, 1997, 2578 liver transplants were performed and 140 (5.4%) recipients received an allograft from a donor with antibodies to HBV. Twenty-five of 48 recipients of a hepatic allograft from a donor positive only for anti-HBs were screened and none developed HBV infection. Twenty-five of 41 naive recipients of a hepatic allograft from an anti-HBc positive donor were screened and 18/25 (72%) developed HBV infection. Four of these 18 naive recipients with HBV infection received an allograft from a donor positive for both anti-HBc and anti-HBs. Seven of 13 anti-HBs-positive recipients of an allograft from an anti-HBc-positive donor were screened and none developed HBV infection. Fifteen of 16 recipients positive only for anti-HBc who received a hepatic allograft from an anti-HBc-positive donor were screened and 2/15 (13%) developed HBV infection.


CONCLUSIONS
Hepatic allografts from donors positive only for anti-HBs do not transmit HBV infection. Hepatic allografts from anti-HBc-positive donors frequently transmit HBV infection to naive recipients regardless of the donor anti-HBs status, and antiviral prophylaxis may be indicated. Anti-HBs-positive recipients appear resistant to HBV infection after orthotopic liver transplantation with an allograft from an anti-HBc-positive donor. Recipients positive only for anti-HBc infrequently develop HBV infection when transplanted with an allograft from an anti-HBc-positive donor; however, HBV prophylaxis may be justified.
Dodson
S F
SF
Thomas E. Starzl Transplantation Institute, Pittsburgh, Pennsylvania 15213, USA.
Issa
S
S
Araya
V
V
Gayowski
T
T
Pinna
A
A
Eghtesad
B
B
Iwatsuki
S
S
Montalvo
E
E
Rakela
J
J
Fung
J J
JJ
D006509:Hepatitis B / Q000635:transmission*; D006510:Hepatitis B Antibodies / Q000032:analysis*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D015996:Survival Rate
D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens