title: Anti-HBs re-seroconversion after liver transplantation in a patient with past HBV infection receiving a HBsAg positive graft.
abstract: OBJECTIVE
  Orthotopic liver transplantation (OLT) is an important therapeutic option for HBV-related end-stage-liver disease, yet it is often hampered by a scarcity of organ availability. One option to increase organ availability is the use of virologically compromised organs from HBV-infected donors. Transplantation of anti-HBcore positive grafts has been associated with a low risk of HBV recurrence if adequately treated with nucleoside analogs, irrespective of concomitant HBV-specific immunoglobulin therapy. Experience using HBsAg positive grafts is, however, very limited.
  
  
  METHODS
  Here, the analysis of the cellular and humoral HBV-specific immunity of a subject with past HBV infection (anti-HBs and anti-HBc positive) receiving an HBsAg positive liver graft is reported.
  
  
  RESULTS
  Nine months post-OLT, the patient experienced a spontaneous anti-HBs re-seroconversion allowing the discontinuation of HBIG. The data show a concurrent increase in the cellular and humoral immunity at times of reduced viral antigenemia, demonstrating effective immune control of HBV post-OLT.
  
  
  CONCLUSIONS
  These data support the use of marginal organs in this setting, providing a potential strategy to further alleviate organ shortage.
authors.affiliation: Department of Clinical Medicine, University of Bologna, Bologna, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Loggi
authors.forename: Florian
authors.initials: F
authors.lastname: Bihl
authors.forename: John V
authors.initials: JV
authors.lastname: Chisholm
authors.forename: Maurizio
authors.initials: M
authors.lastname: Biselli
authors.forename: Andrea
authors.initials: A
authors.lastname: Bontadini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vitale
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ercolani
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Grazi
authors.forename: Antonio D
authors.initials: AD
authors.lastname: Pinna
authors.forename: Mauro
authors.initials: M
authors.lastname: Bernardi
authors.forename: Christian
authors.initials: C
authors.lastname: Brander
authors.forename: Pietro
authors.initials: P
authors.lastname: Andreone
mesh_terms: D000917:Antibody Formation; D000939:Epitopes / Q000032:analysis; D006509:Hepatitis B / Q000276:immunology* / Q000601:surgery*; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006530:Hepatorenal Syndrome / Q000601:surgery; D006801:Humans; D007111:Immunity, Cellular; D008099:Liver / Q000821:virology; D016031:Liver Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors
chemical_list: D000939:Epitopes; D006514:Hepatitis B Surface Antigens