title: Kidney transplantation from anti-HBc+ donors: results from a retrospective Italian study.
abstract: BACKGROUND
  The risk of transmitting a hepatitis B virus (HBV) infection from donor kidneys with a past HBV serological profile may be negligible. Data on HBV transmission to kidney transplant recipients from donor organs that were anti-HBc/HBsAg in Italy has not been previously reported. Anti-HBc testing in cadaver organ donors has been mandatory in Italy since 2002, when anti-HBc determinations were included in the National Guidelines for donor evaluation. Therefore, prior to that date kidney recipients from anti-HBc/HBsAg donors can be identified retrospectively where stored serum is available for testing.
  
  
  METHODS
  The prevalence of anti-HBc Italian organ donors, the incidence of HBV transmission according to the recipients' HBV status (vaccinated, recovered, or naive), and the clinical impact (5-year graft and patient survival rates) in the North Italy Transplant program was evaluated by retrospectively screening for anti-HBc antibodies in the sera of cadaver kidney donors used in transplants from 1997 to 1999.
  
  
  RESULTS
  Two hundred and ten donors were found to have been anti-HBc. At the time of the study, no active infection was observed in any of the 344 HBsAg recipients, but 4/140 (2.86%) of the vaccinated recipients were found to have been anti-HBc/HBsAg. None of these patients, however, had any biochemical or clinical history of HBV infection. Patient and graft survival rates of anti-HBc or anti-HBc kidney recipients did not differ statistically.
  
  
  CONCLUSIONS
  Kidney grafts from anti-HBc donors should be considered in all recipients because the benefit obtained from the transplantation out weighs the negligible risk of HBV transmission.
authors.affiliation: Department Trasfusionale e di Riferimento per il Trapianto di Organi e Tessuti, IRCCS Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy. tullia.defeo@policlinico.mi.it
authors.forename: Tullia M
authors.initials: TM
authors.lastname: De Feo
authors.forename: Paolo
authors.initials: P
authors.lastname: Grossi
authors.forename: Francesca
authors.initials: F
authors.lastname: Poli
authors.forename: Fulvio
authors.initials: F
authors.lastname: Mozzi
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Messa
authors.forename: Enrico
authors.initials: E
authors.lastname: Minetti
authors.forename: Silvio
authors.initials: S
authors.lastname: Sandrini
authors.forename: Luigi
authors.initials: L
authors.lastname: Boschiero
authors.forename: Paolo
authors.initials: P
authors.lastname: Rigotti
authors.forename: Cristina
authors.initials: C
authors.lastname: Maresca
authors.forename: Davide
authors.initials: D
authors.lastname: Rolla
authors.forename: Stefano
authors.initials: S
authors.lastname: Chiaramonte
authors.forename: Eliana
authors.initials: E
authors.lastname: Gotti
authors.forename: Rossana
authors.initials: R
authors.lastname: Caldara
authors.forename: Giulio
authors.initials: G
authors.lastname: Briano
authors.forename: Mario
authors.initials: M
authors.lastname: Scalamogna
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000635:transmission; D006510:Hepatitis B Antibodies / Q000032:analysis* / Q000276:immunology*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D007223:Infant; D007558:Italy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D012189:Retrospective Studies; D014019:Tissue Donors
chemical_list: D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens