title: Impact of anti-hepatitis B core-positive donors in liver transplantation: a survival analysis.
abstract: BACKGROUND
  The current shortage of organs for liver transplantation (OLT) requires expansion of the donor pools. A possible approach to this problem may be the use of donors positive for antibody against hepatitis B core antigen (anti-HBc). However, it is not clear whether recipients who receive anti-HBc-positive livers show worse survival. The aim of this study was to retrospectively analyze the patient and graft survivals of two groups of OLT recipients according to the anti-HBc status of their respective donors.
  
  
  METHODS
  We stratified 133 patients into group 1 (n = 120; anti-core-negative donors) versus group 2 (n = 13; anti-core-positive donors).
  
  
  RESULTS
  Comparing the two groups by univariate analysis, there was no significant differences with regard to recipient, donor, or transplant characteristics. Group 2 showed worse 5-year patient (46.2% vs 72.0%; P = .006) and graft survivals (38.5% vs 68.4%; P = .003). After adjustment for several risk factors for post-OLT death and graft failure, there was no significant difference between patients who received anti-core-positive versus anti-core-negative donors, in terms of patient and graft survivals, particularly only after adjustment for Model for End-stage Liver Disease (MELD) degree of severity.
  
  
  CONCLUSIONS
  The use of anti-HBc-positive donors resulted in worse post-OLT patient and graft survival rates. Unlike the results obtained in the United States, we did not find possible confounders in our results, excluding MELD ≥ 20. However, due to the small size of our cohort, future prospective multicenter studies are required to clarify the safety of anti-core-positive grafts.
authors.affiliation: Department of General Surgery and Organ Transplantation, Sapienza University, Umberto I Hospital, Rome, Italy. lai.quirino@libero.it
authors.forename: Q
authors.initials: Q
authors.lastname: Lai
authors.forename: A
authors.initials: A
authors.lastname: Molinaro
authors.forename: G
authors.initials: G
authors.lastname: Spoletini
authors.forename: G
authors.initials: G
authors.lastname: Mennini
authors.forename: M
authors.initials: M
authors.lastname: Grieco
authors.forename: M
authors.initials: M
authors.lastname: Merli
authors.forename: S G
authors.initials: SG
authors.lastname: Corradini
authors.forename: P B
authors.initials: PB
authors.lastname: Berloco
authors.forename: M
authors.initials: M
authors.lastname: Rossi
mesh_terms: D000328:Adult; D005260:Female; D006512:Hepatitis B Core Antigens / Q000097:blood*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis
chemical_list: D006512:Hepatitis B Core Antigens