title: Renal grafts from anti-hepatitis B core-positive donors: a quantitative review of the literature.
abstract: OBJECTIVE
  Organ shortage is a major problem in transplantation. The use of organs from hepatitis B surface antigen (HBsAg)-negative and hepatitis B core antibody (HBcAb)-positive donors could significantly increase the donor pool. However, little information is available about the impact of HBcAb status of renal donors on viral transmission to recipients. To address this issue, the present quantitative review of relevant studies has been performed.
  
  
  METHODS
  Electronic databases including Medline, EMBASE, ISI, and Scopus were systematically searched for studies that evaluated risk of hepatitis B virus (HBV) transmission through renal transplantation from HBsAg-/HBcAb+ donors. Eligible studies were identified according to predefined criteria. The final outcome was one of HBV markers seroconversion defined as HBsAg, hepatitis B surface antibody (HBsAb), or HBcAb detection in previously seronegative end-stage renal disease (ESRD) patients after transplantation, and without other identified major sources of infection.
  
  
  RESULTS
  Nine studies with 1385 eligible kidney recipients were included. In total, 45 subjects showed seroconversion of HBV markers as follows: HBsAg (n = 4) (0.28%; 95% confidence interval [CI] 0.006; 0.57), HBcAb (n = 32), HBsAb (n = 5), and either HBcAb or HBsAb (n = 4). The total rate of seroconversion after renal transplantation was calculated to be 3.24% (95% CI: 2.31-4.18).
  
  
  CONCLUSIONS
  Our review indicates that the risk of HBV transmission from HBcAb-positive kidney donors is extremely low. Therefore, kidneys from these donors can be transplanted safely into ESRD patients.
authors.affiliation: Tehran Hepatitis Center, Tehran, Iran.
authors.forename: N
authors.initials: N
authors.lastname: Mahboobi
authors.forename: S V
authors.initials: SV
authors.lastname: Tabatabaei
authors.forename: H E
authors.initials: HE
authors.lastname: Blum
authors.forename: S M
authors.initials: SM
authors.lastname: Alavian
mesh_terms: D006509:Hepatitis B / Q000276:immunology / Q000635:transmission* / Q000821:virology; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006515:Hepatitis B virus; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016030:Kidney Transplantation; D014019:Tissue Donors
chemical_list: D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens