title: Four-year follow-up of two chronic hepatitis B recipients of hepatitis B surface antigen-positive cadaveric liver grafts from asymptomatic carriers.
abstract: OBJECTIVE
  Only seven cases of liver transplantation (OLT) with positive serum hepatitis B surface antigen (HBsAg) grafts have been reported in the world till now. Here we report the 4-year follow-up results and clinical pathologic characteristics of two recipients of chronic hepatitis B transplanted with HBsAg-positive cadaveric liver grafts from asymptomatic carriers.
  
  
  METHODS
  Lamivudine combined with hepatitis B immune globulin were used for the control of hepatitis B virus (HBV) infection in both of the recipients post-OLT. The liver functions, virus status and pathologic characteristics of two recipients were followed up according to the rounte protocol of Liver Transplantation Center of West China Hospital.
  
  
  RESULTS
  The serum HBV deoxyribonucleic acid (DNA) turned negative within 30 days post-OLT, but HBsAg remained positive for both of the recipients during follow up. HBV breakthrough occurred in one recipient at the month 12 post-OLT, with detectable serum HBV-DNA (740 copies/mL) and tyrosine-methionine-aspartate-aspartate motif mutation (rtM204I and rtM204V). After the replacement of lamivudine by adefovir dipivoxil 10 mg daily for 2 months, serum HBV-DNA of this recipient became undetectable again and maintained undetectable during follow up. Both of the recipients have survived for more than 4 years post-OLT, with stable liver function and mild hepatitis.
  
  
  CONCLUSIONS
  Due to extreme scarcity of liver graft, we think that HBsAg-positive liver graft without active HBV-DNA replication and severe pathological manifestation from asymptomatic carriers may deserve consideration when no other graft is available in a bearable waiting time.
authors: Department of General Surgery, Gansu Provincial Key Laboratory of Digestive System Tumors, Lanzhou University Second Hospital Department of Nursing, Gansu Provincial Hospital, Lanzhou City, Gansu Province Liver Transplantation Center, Department of General Surgery, West China Hospital, Sichuan University Medical School, Chengdu City, Sichuan Province, China.
authors: Zuoyi
authors: Z
authors: Jiao
authors: Youcheng
authors: Y
authors: Zhang
authors: Lin
authors: L
authors: Han
authors: Yong
authors: Y
authors: Zeng
authors: Lunan
authors: L
authors: Yan