Hepatitis B core antibody-positive grafts: recipient's risk.
The transmission of hepatitis B virus infection through hepatitis B core antibody (anti-HBc)-positive liver grafts in hepatitis B surface antigen (HBsAg)-negative recipients has been established. The mandatory use of immunosuppression in transplant patients favors reactivation of latent virus that may be present in grafts from HBsAg-negative anti-HBc-positive donors. With the persistent organ donor scarcity, the use of these grafts cannot be avoided, especially in urgent cases and in areas where the prevalence of the hepatitis B virus is high, as in Asia. The recognition of posttransplant de novo hepatitis B from core antibody-positive liver donors has, therefore, led to modifications in graft allocation policies and the introduction of strategies for prophylaxis. The risk of developing this type of new-onset hepatitis B virus infection in liver transplant recipients and the various approaches to minimize this risk are reviewed. The peculiar implications of using core antibody-positive grafts in the context of living donor liver transplantation in Asia are discussed.
de Villa
Vanessa H
VH
Liver Transplant Program, Department of Surgery, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan.
Chen
Yaw-Sen
YS
Chen
Chao-Long
CL
D006509:Hepatitis B / Q000635:transmission*; D006510:Hepatitis B Antibodies / Q000032:analysis*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006801:Humans; D008099:Liver / Q000276:immunology*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000276:immunology*; D018570:Risk Assessment
D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens