title: Safety of kidney transplantation using anti-HBc-positive donors.
abstract: BACKGROUND
  Prospective studies evaluating the risk of hepatitis B virus (HBV) transmission in transplants of kidneys from hepatitis B core antibody (anti-HBc)-positive/hepatitis B surface antibody (anti-HBs)-negative donors are still lacking. The objective of this study was to assess the safety of kidney transplantation with the use of anti-HBc-positive donors.
  
  
  METHODS
  This prospective case series study included 50 kidney transplant recipients from anti-HBc-positive donors with or without anti-HBs positivity. Recipients were required to test positive for anti-HBs (titers >10 mUI/mL), regardless of anti-HBc status, and negative for hepatitis B surface antigen (HBsAg). Recipient and donor data were retrieved from medical records, databases, and organ procurement organization sheets. Liver function tests were performed at progressively increasing post-transplantation intervals. Complete serologic tests for HBV were performed before transplantation, 3 and 6 months after transplantation, and annually thereafter.
  
  
  RESULTS
  Six months after transplantation, all recipients were negative for HBsAg, HBeAg, anti-HBe, and anti-HBcIgM. No seroconversion was observed among the 20 patients who received kidneys from anti-HBc-positive/anti-HBs-negative donors. No patient showed elevated liver enzymes during follow-up.
  
  
  CONCLUSIONS
  Kidney transplantation using organs from anti-HBcIgG-positive donors (even when they are concurrently anti-HBs negative) in anti-HBs-positive recipients is a safe procedure and may be considered as a way to expand the donor pool.
authors.affiliation: Department of Internal Medicine, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
authors.forename: J M G
authors.initials: JM
authors.lastname: Abrão
authors.affiliation: Department of Internal Medicine, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
authors.forename: M F C
authors.initials: MF
authors.lastname: Carvalho
authors.affiliation: Department of Internal Medicine, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
authors.forename: P D
authors.initials: PD
authors.lastname: Garcia
authors.affiliation: Department of Internal Medicine, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
authors.forename: M M
authors.initials: MM
authors.lastname: Contti
authors.affiliation: Department of Internal Medicine, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil. Electronic address: landrade@fmb.unesp.br.
authors.forename: L G M
authors.initials: LG
authors.lastname: Andrade
mesh_terms: D000368:Aged; D005260:Female; D006510:Hepatitis B Antibodies / Q000276:immunology*; D006514:Hepatitis B Surface Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014019:Tissue Donors / Q000600:supply & distribution*
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens