title: Successful use of hepatitis B surface antigen-positive liver grafts - an effective source for donor organs in endemic areas: a single-center experience.
abstract: BACKGROUND
  Due to high prevalence of hepatitis B virus (HBV) infection in Taiwan, liver grafts from donors positive for hepatitis B surface antigen (HBsAg) without progressive disease can be effective alternative source of donor organs. This study aims to prove the safety of living donor liver transplantation (LDLT) using HBsAg-positive liver grafts and its long-term outcome.
  
  
  METHODS
  We studied 14 consecutive LDLT recipients that received HBsAg-positive grafts from November 2009 to December 2013 for various indications. All donors were chronic HBsAg carriers with normal liver function tests. Median follow-up was 46 months (range, 35-59).
  
  
  RESULTS
  All the donors and recipients recovered well post-transplant with no reactivation of HBV to date. Two of the recipients died due to extra-hepatic recurrence of HCC. At median follow-up of 46 months, 4-year cumulative survival of recipients was 77.38%.
  
  
  CONCLUSIONS
  In endemic areas, HBsAg-positive donor organs can clearly be used effectively under viral immunoprophylaxis. HBV disease reactivation does not appear to be a threat even with hepatitis B immunoglobulin (HBIG)-free antiviral monoprophylaxis regimen. This study thus proves the safety and feasibility of the option of using HBsAg-positive grafts in high-prevalence areas.
authors.affiliation: Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Long-Bin
authors.initials: LB
authors.lastname: Jeng
authors.affiliation: Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Ashok
authors.initials: A
authors.lastname: Thorat
authors.affiliation: Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Horng-Ren
authors.initials: HR
authors.lastname: Yang
authors.affiliation: Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Yeh
authors.affiliation: Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Te-Hung
authors.initials: TH
authors.lastname: Chen
authors.affiliation: Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chia-Hao
authors.initials: CH
authors.lastname: Hsu
authors.affiliation: Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Shih-Chao
authors.initials: SC
authors.lastname: Hsu
authors.affiliation: College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Kin-Shing
authors.initials: KS
authors.lastname: Poon
authors.affiliation: Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Ping-Chung
authors.initials: PC
authors.lastname: Li
authors.affiliation: College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Hsueh-Chou
authors.initials: HC
authors.lastname: Lai
authors.affiliation: Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Wen-Pang
authors.initials: WP
authors.lastname: Su
authors.affiliation: Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Cheng-Yuan
authors.initials: CY
authors.lastname: Peng
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D006509:Hepatitis B / Q000188:drug therapy / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006801:Humans; D008099:Liver / Q000276:immunology*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens