title: Allografts positive for hepatitis B surface antigen in liver transplant for disease related to hepatitis B virus.
abstract: OBJECTIVE
  Liver grafts from hepatitis B surface antigen-negative and anti-core antibody-positive donors are safe for liver transplant. However, the use of hepatitis B surface antigen-positive liver donors in liver transplants is controversial. We assessed the safety and effectiveness of liver transplants using hepatitis B surface antigen-positive liver grafts to patients with diseases related to hepatitis B virus.
  
  
  METHODS
  We retrospectively reviewed 23 patients who had a deceased-donor liver transplant using hepatitis B surface antigen-positive liver grafts. All patients had end-stage liver disease secondary to hepatitis B virus infection. Recipients had oral entecavir and intravenous or intramuscular injection of hepatitis B immune globulin for >1 year after the transplant.
  
  
  RESULTS
  Two patients died from severe perioperative pneumonia, and the other 21 patients were followed for 9 to 38 months after transplant. All 21 patients remained hepatitis B surface antigen-positive. A repeat liver transplant was performed in 1 patient at 5 months after the initial transplant because of biliary ischemia. There were 3 patients who died from recurrent liver cancer at 9, 14, and 18 months after transplant. There were 18 patients (78%) who survived and 17 grafts (74%) that survived.
  
  
  CONCLUSIONS
  Liver transplant using hepatitis B surface antigen-positive liver grafts is safe for patients with end-stage liver disease secondary to hepatitis B virus infection.
authors.affiliation: Organ Transplantation Center, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China.
authors.forename: Weiqiang
authors.initials: W
authors.lastname: Ju
authors.forename: Maogen
authors.initials: M
authors.lastname: Chen
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Guo
authors.forename: Dongping
authors.initials: D
authors.lastname: Wang
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Zhu
authors.forename: Jiefu
authors.initials: J
authors.lastname: Huang
authors.forename: Xiaoshun
authors.initials: X
authors.lastname: He
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery* / Q000821:virology; D046148:Donor Selection; D004334:Drug Administration Schedule; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006509:Hepatitis B / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000401:mortality / Q000601:surgery* / Q000821:virology; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D007166:Immunosuppressive Agents; C413685:entecavir; D006147:Guanine