title: Hepatitis B prophylaxis in hepatitis B-negative recipients transplanted with donor grafts positive for hepatitis B core antibodies.
abstract: OBJECTIVE
  Use of grafts from hepatitis B (HBV) core antibody (HBcAb(+)) individuals is a routine transplant practice. Herein, we have reported the results of 20 HBV-negative patients transplanted with a HBcAb-positive liver grafts in order to access the efficacy of HBV prophylaxis using immunoglobulin (IE) and antiviral drugs.
  
  
  METHODS
  From January 2004 to December 2009, we performed 168 liver transplantations including 38 HBcAb-positive grafts (22.6%) in 18 cases of HBV-positive recipients and 20 HBV-negative recipients. Histological data obtained from these last 20 grafts during retrieval showed an Ishak 1 score in three and no fibrosis in the other cases. HBV prophylaxis included infusion of 10,000 UI IG during the anhepatic phase and every 24 hours for the first 7 days irrespective of the antibody titer as well as lamivudin (100 mg) administered daily. Once discharged, outpatient management provided modulated IG infusions according to when the antibody titer was lower than 400 UI.
  
  
  RESULTS
  No patient displayed an HBV infection. The overall survival was 80%. Two patients died within the first month after transplantation due to septic complications; one patient succumbed at 24 months after transplantation because of a lymphoproliferative malignancy and another died due to an aggressive hepatitis C virus recurrence at 6 months post transplant.
  
  
  CONCLUSIONS
  By using appropriate anti-HBV prophylaxis, HBcAb-positive grafts can be used safely for HBcAb-negative recipients.
authors.affiliation: Hepato-Biliary Surgery and Liver Transplant Unit, A. Cardarelli Hospital, Naples, Italy. scuderi.enzo@gmail.com
authors.forename: V
authors.initials: V
authors.lastname: Scuderi
authors.forename: A
authors.initials: A
authors.lastname: Ceriello
authors.forename: W
authors.initials: W
authors.lastname: Santaniello
authors.forename: G
authors.initials: G
authors.lastname: Aragiusto
authors.forename: M
authors.initials: M
authors.lastname: Romano
authors.forename: C
authors.initials: C
authors.lastname: Migliaccio
authors.forename: F
authors.initials: F
authors.lastname: Calise
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage; D005260:Female; D006509:Hepatitis B / Q000188:drug therapy / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000276:immunology*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D019259:Lamivudine