title: Influence of HBcAb positivity in the organ donor in heart transplantation.
abstract: OBJECTIVE
  There is a significant risk of hepatitis B transmission from HBsAg (-), HBcAb (+) donors in liver transplantation, but there is little information about hepatitis B transmission from HBcAb heart donors. The present study examines the influence of HBcAb presence in relation to heart donor acceptance and offers an update of the published studies.
  
  
  METHODS
  Survey and medical database update from 1994 to October 2011.
  
  
  METHODS
  Spanish heart transplantation teams.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Acceptance of heart transplant from an HBcAb (+) organ donor.
  
  
  RESULTS
  Twelve out of 15 surveyed teams were seen to vaccinate against HBV, and two quantify HBsAb titers. Seven teams specifically request donor HBcAb status. If the latter proves positive, two do not accept transplantation, two accept if the donor is also HBsAb (+), one selects the receptor under emergency conditions, and three use drug prophylaxis isolatedly or complementary to the above. Only one case of hepatitis B has been reported in a HBcAb (-) and HBsAb (-) receptor that did not receive prophylactic measures. There have been reports of seroconversion of the HBcAb and HBsAb markers, though with an uncertain etiology.
  
  
  CONCLUSIONS
  HBcAb seropositivity influences acceptance of a heart donor, but agreement is lacking. There is limited information on receptor evolution. To date there has been one reported case of hepatitis B after heart transplant. Although rare, an HBcAb (+) donor can harbor occult HBV infection. The risk of infection can be prevented with appropriate HBsAb titers following vaccination or by pharmacological measures.
authors.affiliation: Oficina Regional de Trasplantes de Comunidad de Madrid, Madrid, Spain. carlos.chamorroj@salud.madrid.org
authors.forename: C
authors.initials: C
authors.lastname: Chamorro
authors.forename: M
authors.initials: M
authors.lastname: Aparicio
mesh_terms: D000465:Algorithms; D016027:Heart Transplantation; D006509:Hepatitis B / Q000276:immunology / Q000635:transmission; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000276:immunology; D006801:Humans; D017410:Practice Guidelines as Topic; D013030:Spain; D011795:Surveys and Questionnaires; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000592:standards*
chemical_list: D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens