title: Living donor liver transplant with clinical tolerance, laboratory evidence of chimerism, and spontaneous clearance of HBV.
abstract: We present a case of functional and histopathologic tolerance, chimerism, and spontaneous clearance of HBV in a patient four years after living donor liver transplant (LDLT). A 19-year-old male patient underwent a LDLT for HBV cirrhosis. He voluntarily ceased immunosuppression and antiviral therapy after 6 months. He is now four years status post transplant without any episodes of rejection or clinical manifestation of liver disease. PCR and VNTR were used to show donor-recipient chimerism and a large degree of genetic similarity between the pair. MLC and cytokine elaboration were used to show recipient hyporeactivity towards donor antigen. He also has clinical evidence of clearing his HBV without continued use of HBIG.
authors.affiliation: Department of Surgery, Division of Transplantation, Hepatology Section, Medical College of Virginia Hospitals, Commonwealth University Health Care Systems, Richmond, VA 23298, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: Stone
authors.forename: Seong-Hwan
authors.initials: SH
authors.lastname: Chang
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Kimball
authors.forename: R Todd
authors.initials: RT
authors.lastname: Stravitz
authors.forename: Robert A
authors.initials: RA
authors.lastname: Fisher
mesh_terms: D000328:Adult; D046528:Chimerism; D006509:Hepatitis B / Q000150:complications / Q000276:immunology* / Q000601:surgery; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000601:surgery; D016031:Liver Transplantation / Q000276:immunology*; D019520:Living Donors; D008297:Male; D012075:Remission, Spontaneous; D023001:Transplantation Tolerance / Q000276:immunology*