Safety and outcome of hepatitis B core antibody-positive donors in right-lobe living donor liver transplantation.
We studied the safety of right-lobe donor hepatectomy in living donors with a positive serological test result for antibody against hepatitis B core antigen (anti-HBc). Of 54 right-lobe living liver donors, serum anti-HBc was positive in 29 donors (54%) and negative in 25 donors (46%). None had a history of hepatitis and all had normal liver biochemistry test results before surgery. Surgical data, postoperative liver function, and outcome of donors were compared according to anti-HBc status. Donors positive for anti-HBc were significantly older (median age, 42 v 31 years; P <.001), but there was no difference in other demographics and liver size. Median blood loss was greater in anti-HBc-positive donors (600 v 350 mL; P =.007). Histological examination showed no difference in degree of portal fibrosis or fatty change in liver grafts. There was no significant difference in postoperative serum transaminase levels or prothrombin times; however, anti-HBc-positive donors had greater serum bilirubin levels day 6 (26 v 21 micromol/L; P =.01) and day 7 (22 v 15 micromol/L; P =.004) after surgery. Postoperative complications developed in 10 anti-HBc-positive and 6 anti-HBc-negative donors (P =.4). All donors who developed cholestasis were positive for anti-HBc, aged 45 years or older, and had mild fatty changes of the liver. Hospital stays were similar. All donors had completely normal liver function at a median follow-up of 31 months (range, 21 to 76 months). A positive serological test result for anti-HBc should not be regarded as a contraindication for right-lobe liver donation.
Lo
Chung-Mau
CM
Department of Surgery, Centre for the Study of Liver Disease, University of Hong Kong Medical Centre, Hong Kong, China. chungmlo@hkucc.hku.hk
Fan
Sheung-Tat
ST
Liu
Chi-Leung
CL
Yong
Boon-Hun
BH
Wong
Yik
Y
Ng
Irene Oi-Lin
IO
Wong
John
J
D000328:Adult; D001663:Bilirubin / Q000097:blood; D005260:Female; D006510:Hepatitis B Antibodies; D006801:Humans; D016031:Liver Transplantation / Q000276:immunology* / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome
D006510:Hepatitis B Antibodies; D001663:Bilirubin