A comprehensive study of the safety of using anti-hepatitis B core (Hbc) positive subjects in living donor liver transplants.
OBJECTIVE
In recent years, only few reports have addressed the safety of using living donors with a positive anti-Hepatitis B Core (HBc) antibody for liver transplants. Most reports have focused on short-term complications, short-term changes in liver function and regeneration of remnant liver. Long term follow-up data, quality of life and overall laboratory tests variations have not been appropriately studied. In our study, we aim to comprehensively investigate the safety of using anti-HBc-positive subjects in living donor liver transplants (LDLT).


METHODS
From March 2003 to March 2008, a total of 60 of LDLT cases were studied. All cases were right lobe transplants. Thirty donors with a positive anti-HBc were included in one group (group 1). The other 30 donors with a negative anti-HBc were included in Group 2. Preoperative parameters, intra-operative data, postoperative short- and long-term complications, laboratory tests and quality of life after surgery were compared.


RESULTS
Preoperative demographic data, intra-operative data and graft size comparisons from both groups showed non-significant differences. Anti-HBc-positive donors (9 cases; 30%) showed more complications than negative donors (7 cases; 23.3%). However, the increase did not reach statistical significance (p = 0.563). The quality of life, postoperative serum Transaminase levels, prothrombin times and routine blood values showed non-significant differences. Anti-HBc positive donors showed higher levels of total bilirubin (TB), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) within the first 7 postoperative days. Nonetheless, all levels showed similar values for both groups in the days immediately following surgery. All indexes returned to normal levels, thirty days after surgery. However, a persistently decreased platelet count was observed in both groups.


CONCLUSIONS
A positive serological test result for anti-HBc should not be considered as an absolute contraindication for LDLT. However, these cases require more caution than negative donors.
Jianyong
J
Lei
Lunan
L
Yan
Wentao
W
Wang
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006801:Humans; D008099:Liver / Q000503:physiopathology; D016031:Liver Transplantation / Q000009:adverse effects; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010976:Platelet Count
D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase