title: Use of kidney donors with hepatitis B, hepatitis C, or brain tumor: a single-center experience.
abstract: BACKGROUND
  With the rapid increase in the number of patients on the waiting lists, the idea of using organs from donors who were previously classified as "marginal" has emerged. The aim of this study was to evaluate the clinical outcomes of the patients who received kidneys from donors with hepatitis B, hepatitis C, or brain tumors.
  
  
  METHODS
  Between 2003 and 2010, 27 transplantations were performed from donors with hepatitis B, hepatitis C or brain tumors between 2003 and 2010. Demographic and clinical characteristics of donors and recipients were retrospectively collected from medical files.
  
  
  RESULTS
  Fifteen patients received kidneys from donors with hepatitis B: 9 from deceased donors having a positive hepatitis B surface antigen (HBsAg) and six from living donors with positive HBsAg having negative results of qualitative hepatitis B DNA analysis. Two of the fifteen recipients were previously diagnosed with chronic active mild hepatitis B infection. The remaining 13, who were HBsAg (-)/anti-HBs(+) at the time of transplantation, underwent hepatitis B immune globulin and lamivudine therapy. Median follow up time was 40 ± 35 months. One patient developed decompensated liver disease owing to noncompliance to lamivudine therapy. Five patients who received grafts from anti-HCV(+) deceased donors were anti-HCV(+) at the time of transplantation with alanine aminotransferase (ALT) levels <40 U/L. All grafts remained functional at a median of 70 months. Seven subjects received grafts from deceased donors with brain tumors, none of whom had a history of a craniotomy or a ventriculoperitoneal shunt. All recipients had serious vascular access problems. No graft loss or de novo malignancies was observed among these patients after a median follow-up of 69 ± 26 months.
  
  
  CONCLUSIONS
  With appropriate patient selection, the donated organ pool can be expanded by addition of donors with hepatitis or brain tumors.
authors: Division of Nephrology, Ege University School of Medicine, Izmir, Turkey. etatar@hotmail.com
authors: E
authors: E
authors: Tatar
authors: M N
authors: MN
authors: Turan
authors: O
authors: O
authors: Firat
authors: T O
authors: TO
authors: Sezer
authors: M
authors: M
authors: Sozbilen
authors: I
authors: I
authors: Solak
authors: H
authors: H
authors: Toz
authors: C
authors: C
authors: Hoscoskun
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001932:Brain Neoplasms / Q000150:complications* / Q000175:diagnosis; D004279:DNA, Viral / Q000097:blood; D046148:Donor Selection; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000627:therapeutic use; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D018937:Hepatitis C Antibodies; D007166:Immunosuppressive Agents; D000410:Alanine Transaminase