Successful living donor liver transplantation using a graft from a hepatitis B surface antigen-positive donor.
OBJECTIVE
Liver transplantation using a graft from a donor with a positive hepatitis B surface antigen (HBsAg) has been contraindicated owing to the extremely high risk for recurrent disease leading to graft loss. However, the severe shortage of donors often forces the transplant community to utilize suboptimal donors, especially in the setting of living donor liver transplantation (LDLT).


METHODS
Here, we report a case of successful LDLT for a patient with hepatitis B-related cirrhosis utilizing a graft from an HBsAg-positive 'healthy carrier' donor using a combination prophylaxis of lamivudine and adefovir dipivoxil.


RESULTS
To date, the patient has been doing well with normal liver function tests and liver histological findings at 4 years after the transplantation and the donor has also been doing well.


CONCLUSIONS
Although virological recurrence appears to be universal despite prophylaxis, re-evaluation of the use of a graft from a healthy HBsAg-positive donor is warranted in this era of combination prophylaxis.
Soejima
Yuji
Y
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. ysoejima@surg2.med.kyushu-u.ac.jp
Shimada
Mitsuo
M
Taketomi
Akinobu
A
Yoshizumi
Tomoharu
T
Uchiyama
Hideaki
H
Ikegami
Toru
T
Nakamuta
Makoto
M
Maehara
Yoshihiko
Y
D005260:Female; D006085:Graft Survival; D006509:Hepatitis B / Q000276:immunology / Q000601:surgery*; D006514:Hepatitis B Surface Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000472:pathogenicity; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008875:Middle Aged
D006514:Hepatitis B Surface Antigens