title: Solid organ transplantation from hepatitis B virus-positive donors: consensus guidelines for recipient management.
abstract: Use of organs from donors testing positive for hepatitis B virus (HBV) may safely expand the donor pool. The American Society of Transplantation convened a multidisciplinary expert panel that reviewed the existing literature and developed consensus recommendations for recipient management following the use of organs from HBV positive donors. Transmission risk is highest with liver donors and significantly lower with non-liver (kidney and thoracic) donors. Antiviral prophylaxis significantly reduces the rate of transmission to liver recipients from isolated HBV core antibody positive (anti-HBc+) donors. Organs from anti-HBc+ donors should be considered for all adult transplant candidates after an individualized assessment of the risks and benefits and appropriate patient consent. Indefinite antiviral prophylaxis is recommended in liver recipients with no immunity or vaccine immunity but not in liver recipients with natural immunity. Antiviral prophylaxis may be considered for up to 1 year in susceptible non-liver recipients but is not recommended in immune non-liver recipients. Although no longer the treatment of choice in patients with chronic HBV, lamivudine remains the most cost-effective choice for prophylaxis in this setting. Hepatitis B immunoglobulin is not recommended.
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: S
authors.initials: S
authors.lastname: Huprikar
authors.forename: L
authors.initials: L
authors.lastname: Danziger-Isakov
authors.forename: J
authors.initials: J
authors.lastname: Ahn
authors.forename: S
authors.initials: S
authors.lastname: Naugler
authors.forename: E
authors.initials: E
authors.lastname: Blumberg
authors.forename: R K
authors.initials: RK
authors.lastname: Avery
authors.forename: C
authors.initials: C
authors.lastname: Koval
authors.forename: E D
authors.initials: ED
authors.lastname: Lease
authors.forename: A
authors.initials: A
authors.lastname: Pillai
authors.forename: K E
authors.initials: KE
authors.lastname: Doucette
authors.forename: J
authors.initials: J
authors.lastname: Levitsky
authors.forename: M I
authors.initials: MI
authors.lastname: Morris
authors.forename: K
authors.initials: K
authors.lastname: Lu
authors.forename: J K
authors.initials: JK
authors.lastname: McDermott
authors.forename: T
authors.initials: T
authors.lastname: Mone
authors.forename: J P
authors.initials: JP
authors.lastname: Orlowski
authors.forename: D M
authors.initials: DM
authors.lastname: Dadhania
authors.forename: K
authors.initials: K
authors.lastname: Abbott
authors.forename: S
authors.initials: S
authors.lastname: Horslen
authors.forename: B L
authors.initials: BL
authors.lastname: Laskin
authors.forename: A
authors.initials: A
authors.lastname: Mougdil
authors.forename: V L
authors.initials: VL
authors.lastname: Venkat
authors.forename: K
authors.initials: K
authors.lastname: Korenblat
authors.forename: V
authors.initials: V
authors.lastname: Kumar
authors.forename: P
authors.initials: P
authors.lastname: Grossi
authors.forename: R D
authors.initials: RD
authors.lastname: Bloom
authors.forename: K
authors.initials: K
authors.lastname: Brown
authors.forename: C N
authors.initials: CN
authors.lastname: Kotton
authors.forename: D
authors.initials: D
authors.lastname: Kumar
mesh_terms: D000998:Antiviral Agents / Q000737:chemistry / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D016027:Heart Transplantation / Q000379:methods; D006509:Hepatitis B / Q000517:prevention & control* / Q000821:virology; D006510:Hepatitis B Antibodies / Q000276:immunology; D006512:Hepatitis B Core Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods; D019259:Lamivudine / Q000627:therapeutic use; D016031:Liver Transplantation / Q000379:methods*; D012955:Societies, Medical; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D014481:United States
chemical_list: D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D019259:Lamivudine
keywords: clinical research/practice; donors and donation: donor-derived infections; infection and infectious agents; infectious disease; viral: hepatitis B