title: Effect of prior hepatitis B virus exposure on long-term risk of liver-related events after liver transplantation.
abstract: OBJECTIVE
  To characterize the risk of liver-related events and death in hepatitis B virus (HBV)-exposed liver transplantation (LT) recipients.
  
  
  METHODS
  Retrospective review was performed in all adults who underwent LT between January 1995 through December 2010 at the Johns Hopkins Hospital. Recipients with graft failure or death within 14 d of LT or missing HBV status were excluded, leaving 575 individuals for analysis. Patients were classified according to HBV exposure status: Unexposed, Resolved HBV, Chronic HBV, or hepatitis B core antibody (anti-HBc) seropositive liver donor.
  
  
  RESULTS
  Compared with HBV-unexposed patients, the relative hazard of combined liver-related events (rejection, cirrhosis, re-transplantation) and death after LT was not increased in patients with a baseline history of resolved HBV infection or chronic hepatitis B. Using anti-HBc seropositive donors also did not increase the risk of liver-related events, death, or composite events (all p ≥ 0.05). However, hepatitis C was associated with liver-related events [adjusted hazard ratio (aHR), 1.59; 95% confidence interval (CI), 1.00-2.52], and blacks had a higher risk of death (aHR, 1.50; 95% CI, 1.01-2.22).
  
  
  CONCLUSIONS
  LT of patients with prior HBV exposure or use of anti-HBc seropositive donors is not associated with increased risk of liver-related events or death.
authors.affiliation: Division of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Po-Hung
authors.initials: PH
authors.lastname: Chen
authors.affiliation: Division of Gastroenterology & Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Berkeley N
authors.initials: BN
authors.lastname: Limketkai
authors.affiliation: Division of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Trilianos
authors.affiliation: Division of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Muge
authors.initials: M
authors.lastname: Pirtini-Cetingul
authors.affiliation: Division of Gastroenterology, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX, USA.
authors.forename: Tinsay A
authors.initials: TA
authors.lastname: Woreta
authors.affiliation: Division of Gastrointestinal & Liver Diseases, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Murat T
authors.initials: MT
authors.lastname: Gulsen
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Dorry L
authors.initials: DL
authors.lastname: Segev
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Cameron
authors.affiliation: Division of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Gurakar
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology*; D006085:Graft Survival; D006509:Hepatitis B / Q000635:transmission* / Q000821:virology; D006510:Hepatitis B Antibodies / Q000276:immunology*; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D006510:Hepatitis B Antibodies
keywords: graft survival; hepatitis B; liver transplantation; mortality