Safety of using hepatitis B virus core antibody or surface antigen-positive donors in kidney or pancreas transplantation.
Hepatitis B virus core antibody (HBcAb) or surface antigen (HBsAg)-positive organ donors have the potential to transmit infection to transplant recipients. We investigated the safety of using HBcAb(+) or HBsAg(+) donors in kidney or pancreas transplant recipients with 1 yr lamivudine prophylaxis. While HBsAb(-) recipients of HBcAb(+) donors received prophylaxis, HBsAb(+) recipients did not. HBsAg(+) organs were only used in patients who were both HBcAb and HBsAb(+). Forty-six patients received HBcAb(+) and four received HBsAg(+) organs (47 kidney, two pancreas, and one kidney/pancreas). All but one recipient were HBsAg(-), 25 were HBsAb(+), and 19 HBcAb(+). During a median 36 months of follow-up (range 6-66 months), with 43 of a total 50 patients having at least 1 yr follow-up and were off lamivudine, and none of the patients developed hepatitis B viremia or seroconversion to HBsAg or HBsAb(+). These results suggest that HBcAb(+) or HBsAg(+) organs can be used safely in selected recipients with lamivudine prophylaxis without requiring hepatitis B immunglobulin.
Akalin
Enver
E
Nephrology Institute, Mount Sinai School of Medicine, New York, NY, USA. akalin@msnyuhealth.org
Ames
Scott
S
Sehgal
Vinita
V
Murphy
Barbara
B
Bromberg
Jonathan S
JS
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D018890:Chemoprevention; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control*; D006512:Hepatitis B Core Antigens / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects*
D000998:Antiviral Agents; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D019259:Lamivudine