title: Safety of Monitoring Viral and Liver Function Markers in Patients With Prior Resolved Hepatitis B Infection After Kidney Transplantation.
abstract: BACKGROUND
  Hepatitis B virus (HBV) infection is a risk factor of mortality in kidney transplant recipients. However, information on the risk of HBV reactivation in kidney recipients with prior resolved HBV infection is limited. This study aimed to evaluate the safety of simply monitoring viral and liver markers in living donor kidney transplantation (LDKT) recipients with prior resolved HBV infection.
  
  
  METHODS
  We retrospectively examined the clinical records of LDKT recipients. Changes in the levels of alanine aminotransferase, aspartate aminotransferase, hepatitis B surface antigen (HBs Ag), surface antibody, core antibody, and HBV-DNA after transplantation were evaluated, and the occurrence of de novo HBV-related hepatitis and allograft function were monitored.
  
  
  RESULTS
  Of 61 consecutive LDKT patients, seven had prior resolved HBV infection. Four patients underwent ABO-compatible LDKT, whereas two underwent ABO-incompatible LDKT. The median age was 64 years (range, 61-69 years), and two patients were women. The causes of end-stage kidney disease were diabetic nephropathy, hypertensive nephrosclerosis, and chronic glomerulonephritis. Five patients were referred to hepatologists. The history of HBV vaccination was not confirmed in all patients. Prophylaxis with entecavir was administered to two patients with ABO-incompatible LDKT before transplantation. All patients tested negative for HBs Ag and HBV-DNA throughout observation, and none developed de novo HBV-related hepatitis or graft loss.
  
  
  CONCLUSIONS
  Patients with HBV infection without HBV DNA positivity are eligible for kidney transplants without antiviral therapy, even those on rituximab therapy. Monitoring viral and liver markers combined with hepatologist consultations may ensure safe follow-up in LDKT recipients with prior resolved HBV infection.
authors: Division of Nephrology and Endocrinology, The University of Tokyo, Japan. Electronic address: md_maekawa@yahoo.co.jp.
authors: H
authors: H
authors: Maekawa
authors: Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Miyamae-ku, Kanagawa, Japan.
authors: M
authors: M
authors: Yazawa
authors: Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Miyamae-ku, Kanagawa, Japan.
authors: K
authors: K
authors: Koitabashi
authors: Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Miyamae-ku, Kanagawa, Japan.
authors: N
authors: N
authors: Imai
authors: Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Miyamae-ku, Kanagawa, Japan.
authors: H
authors: H
authors: Kawarazaki
authors: Department of Urology, St. Marianna University School of Medicine, Miyamae-ku, Kanagawa, Japan.
authors: R
authors: R
authors: Nakazawa
authors: Department of Urology, St. Marianna University School of Medicine, Miyamae-ku, Kanagawa, Japan.
authors: H
authors: H
authors: Sasaki
authors: Department of Urology, St. Marianna University School of Medicine, Miyamae-ku, Kanagawa, Japan.
authors: T
authors: T
authors: Chikaraishi
authors: Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Miyamae-ku, Kanagawa, Japan.
authors: Y
authors: Y
authors: Shibagaki
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000601:surgery* / Q000821:virology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D007136:Immunoglobulins; C413685:entecavir; D006147:Guanine; D000410:Alanine Transaminase