Living donor liver transplantation from hepatitis B core antibody positive donors.
Liver allografts from donors previously exposed to hepatitis B virus (HBV) carry the risk of transmission of HBV infection to immunosuppressed recipients. However, exclusion of donor candidates with the serologic evidence of resolved hepatitis B-HBV surface antigen (HbsAg) negative and HBV core antibody (anti-HBc) positive-is not feasible in countries endemic for HBV.


OBJECTIVE
Our aim was to assess the safety of living donor liver transplantation from anti-HBc positive donors.


METHODS
In our institution, 152 transplants were performed between June 1999 and April 2004. Fifty-six (37%) of the living donors were anti-HBc positive. Twenty of these liver grafts were transplanted to HbsAg-negative recipients. We excluded four HBsAg negative recipients who died because of early complications after transplantation. Lamivudine (100 mg/day) was given for prophylaxis of de novo HBV infection.


RESULTS
The mean follow-up time for 16 HBsAg-negative recipients was 21.7 (7-48) months. None of them experienced de novo HBV infection.


CONCLUSIONS
The use of liver allografts from anti-HBc-positive living donors is reasonably safe in HBsAg-negative recipients under lamivudine prophylaxis.
Celebi Kobak
A
A
Department of Gastroenterology, General Surgery, and Microbiology, Ege University Faculty of Medicine, Izmir, Turkey. arzukobak@yahoo.com
Karasu
Z
Z
Kilic
M
M
Ozacar
T
T
Tekin
F
F
Gunsar
F
F
Ersoz
G
G
Yuzer
Y
Y
Tokat
Y
Y
D006509:Hepatitis B / Q000453:epidemiology; D006512:Hepatitis B Core Antigens / Q000097:blood*; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000627:therapeutic use*; D019259:Lamivudine / Q000627:therapeutic use; D016031:Liver Transplantation; D019520:Living Donors; D018579:Patient Selection; D015995:Prevalence; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D014421:Turkey / Q000453:epidemiology
D006512:Hepatitis B Core Antigens; D007136:Immunoglobulins; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; C045213:hepatitis B hyperimmune globulin