Hematopoietic stem cell transplantation from non-replicative hepatitis B virus carriers is safe.
OBJECTIVE
Hepatitis B virus can cause serious problems in individuals undergoing organ transplantation. The aim of this study was to evaluate the hepatic events among HBs-Ag positive recipients and HBs-Ag negative recipients who received products from hepatitis B virus carriers.


METHODS
A total of 151 patients received an allogeneic hematopoietic stem cell transplantation at the Department of Hematology-Oncology, University of Ankara, between June 1989 and June 1998. Among these, eight HBs-Ag positive and four HBs-Ag negative recipients received a product from a hepatitis B virus positive donor. The median follow-up period for these 12 patients was 13.2 months.


RESULTS
Three of the eight HBs-Ag positive recipients died (one from hepatic failure); of the remainder, two are HBs-Ag negative, two HBs-Ag positive with normal liver injury tests and one HBs-Ag positive with elevated ALT levels. Of the four HBs-Ag negative recipients who received stem cells from a hepatitis B positive donor, two died; none of the patients in this group became HBs-Ag positive after transplantation.


CONCLUSIONS
Hepatitis B virus infection is a common problem in patients being considered for allogeneic hematopoetic stem cell transplantation, especially in areas where hepatitis B virus infection is endemic. We believe that the presence of HBs-Ag positivity is not an absolute contraindication for allogeneic hematopoetic stem cell transplantation unless the hepatitis B virus is in a replication phase.
Ustün
C
C
University of Ankara, Medical School, Department of Hematology-Oncology, Turkey.
Idilman
R
R
Gürman
G
G
Ozcan
M
M
Akyol
G
G
Akan
H
H
Ilhan
O
O
Beksaç
M
M
Uysal
A
A
Konuk
N
N
Karayalçin
S
S
Poyraz
A
A
Van Thiel
D
D
Koç
H
H
D000293:Adolescent; D000328:Adult; D002353:Carrier State / Q000276:immunology* / Q000821:virology; D000075202:Contraindications; D017809:Fatal Outcome; D018380:Hematopoietic Stem Cell Transplantation; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control* / Q000635:transmission; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000472:pathogenicity*; D006801:Humans; D007113:Immunity, Innate; D007165:Immunosuppression Therapy; D016219:Immunotherapy, Adoptive; D008297:Male; D008875:Middle Aged; D014779:Virus Replication
D006514:Hepatitis B Surface Antigens