title: Inferior graft survival of hepatitis B core positive grafts is not influenced by post-transplant hepatitis B infection in liver recipients--5-year single-center experience.
abstract: Nonoptimal liver grafts, and among them organs from anti-HBc+ donors, are increasingly used for liver transplantation. In this retrospective study including 1065 adult liver transplantations performed between 1977 and 2012, we analyzed long-term patient and graft survival and occurrence of HBV infection. A total of 52 (5.1%) patients received an anti-HBc+ graft. The 10-year graft and patient survival of these recipients were 50.9% and 59.0% compared to 72.0% and 76.5% (P = 0.001; P = 0.004) of patients receiving anti-HBc- grafts, respectively. Cox regression model showed that high urgency allocation (P = 0.003), recipient age (P = 0.027), anti-HCV+ recipients (P = 0.005), and anti-HBc+ organs (P = 0.048) are associated with decreased graft survival. Thirteen of 52 (25.0%) patients receiving anti-HBc+ grafts developed post-transplant HBV infection within a mean of 2.8 years. In this study, antiviral prophylaxis did not have significant impact on HBV infection, but long-term survival (P = 0.008). Development of post-transplant HBV infection did not affect adjusted 10-year graft survival (100% vs. 100%; P = 1). Anti-HBc+ liver grafts can be transplanted with reasonable but inferior long-term patient and graft survival. The inferior graft survival is not, however, related with post-transplant HBV infection as long as early diagnosis and treatment take place.
authors.affiliation: Department of Visceral-, Transplant-, and Thoracic Surgery, Medical University, Innsbruck, Austria.|Department of General, Visceral, Vascular and Thoracic Surgery, Charité Campus Mitte, Berlin, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Brandl
authors.affiliation: Department of Visceral-, Transplant-, and Thoracic Surgery, Medical University, Innsbruck, Austria.
authors.forename: Philipp
authors.initials: P
authors.lastname: Stolzlechner
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, Medical University, Innsbruck, Austria.
authors.forename: Stephan
authors.initials: S
authors.lastname: Eschertzhuber
authors.affiliation: Department of Visceral-, Transplant-, and Thoracic Surgery, Medical University, Innsbruck, Austria.|Department of Anaesthesia and Intensive Care Medicine, Medical University, Innsbruck, Austria.
authors.forename: Felix
authors.initials: F
authors.lastname: Aigner
authors.affiliation: Department of Visceral-, Transplant-, and Thoracic Surgery, Medical University, Innsbruck, Austria.|Department of General, Visceral, Vascular and Thoracic Surgery, Charité Campus Mitte, Berlin, Germany.
authors.forename: Sascha
authors.initials: S
authors.lastname: Weiss
authors.affiliation: Department of Internal Medicine II, Gastroenterology & Hepatology, Medical University, Innsbruck, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Vogel
authors.affiliation: Department of Biostatistics, Coordination Center for Clinical Trials, Charité Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Krannich
authors.affiliation: Department of Medical Statistics, Medical University, Innsbruck, Austria.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Neururer
authors.affiliation: Department of Visceral-, Transplant-, and Thoracic Surgery, Medical University, Innsbruck, Austria.|Department of General, Visceral and Transplant Surgery, Charité Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Johann
authors.initials: J
authors.lastname: Pratschke
authors.affiliation: Department of Internal Medicine II, Gastroenterology & Hepatology, Medical University, Innsbruck, Austria.|Department of Internal Medicine, District Hospital Hall, Innsbruck, Austria.
authors.forename: Ivo
authors.initials: I
authors.lastname: Graziadei
authors.affiliation: Department of Visceral-, Transplant-, and Thoracic Surgery, Medical University, Innsbruck, Austria.|Department of General, Visceral and Transplant Surgery, Charité Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Öllinger
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D006085:Graft Survival; D006509:Hepatitis B / Q000473:pathology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006512:Hepatitis B Core Antigens / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens
keywords: Lamivudine resistance; anti-HBc+ grafts; antiviral prophylaxis; post-transplant HBV infection