Anti-HBs re-seroconversion after liver transplantation in a patient with past HBV infection receiving a HBsAg positive graft.
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.
Loggi
Elisabetta
E
Department of Clinical Medicine, University of Bologna, Bologna, Italy.
Bihl
Florian
F
Chisholm
John V
JV
Biselli
Maurizio
M
Bontadini
Andrea
A
Vitale
Giovanni
G
Ercolani
Giorgio
G
Grazi
Gian Luca
GL
Pinna
Antonio D
AD
Bernardi
Mauro
M
Brander
Christian
C
Andreone
Pietro
P
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
D000939:Epitopes; D006514:Hepatitis B Surface Antigens