Liver grafts from hepatitis B surface antigen-positive donors: A review of the literature.
The scarcity of available organs and the gap between supply and demand continue to be the main limitations of liver transplantation. To relieve the organ shortage, current transplant strategies have implemented extended criteria, which include the use of liver from patients with signs of past or present hepatitis B virus (HBV) infection. While the use of liver grafts from donors with evidence of past HBV infection is quite limited, some data have been collected regarding the feasibility of transplanting a liver graft from a hepatitis B surface antigen (HBsAg) positive donor. The aim of the present work was to review the literature regarding liver transplants from HBsAg-positive donors. A total of 17 studies were identified by a search in Medline. To date, HBsAg positive grafts have preferentially been allocated to HBsAg positive recipients. The large majority of these patients continue to be HBsAg positive despite the use of immunoglobulin, and infection prevention can only be guaranteed by using antiviral prophylaxis. Although serological persistence is evident, no significant HBV-related disease has been observed, except in patients coinfected with delta virus. Consistently less data are available for HBsAg negative recipients, although they are mostly promising. HBsAg-positive grafts could be an additional organ source for liver transplantation, provided that the risk of reinfection/reactivation is properly prevented.
Elisabetta Loggi, Fabio Conti, Alessandro Cucchetti, Giorgio Ercolani, Antonio Daniele Pinna, Pietro Andreone, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi di Bologna, 40138 Bologna, Italy.
Elisabetta
E
Loggi
Elisabetta Loggi, Fabio Conti, Alessandro Cucchetti, Giorgio Ercolani, Antonio Daniele Pinna, Pietro Andreone, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi di Bologna, 40138 Bologna, Italy.
Fabio
F
Conti
Elisabetta Loggi, Fabio Conti, Alessandro Cucchetti, Giorgio Ercolani, Antonio Daniele Pinna, Pietro Andreone, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi di Bologna, 40138 Bologna, Italy.
Alessandro
A
Cucchetti
Elisabetta Loggi, Fabio Conti, Alessandro Cucchetti, Giorgio Ercolani, Antonio Daniele Pinna, Pietro Andreone, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi di Bologna, 40138 Bologna, Italy.
Giorgio
G
Ercolani
Elisabetta Loggi, Fabio Conti, Alessandro Cucchetti, Giorgio Ercolani, Antonio Daniele Pinna, Pietro Andreone, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi di Bologna, 40138 Bologna, Italy.
Antonio Daniele
AD
Pinna
Elisabetta Loggi, Fabio Conti, Alessandro Cucchetti, Giorgio Ercolani, Antonio Daniele Pinna, Pietro Andreone, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi di Bologna, 40138 Bologna, Italy.
Pietro
P
Andreone
D000998:Antiviral Agents / Q000627:therapeutic use; D006085:Graft Survival; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000737:chemistry; D006512:Hepatitis B Core Antigens / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000737:chemistry* / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D008099:Liver / Q000276:immunology; D017093:Liver Failure / Q000601:surgery* / Q000628:therapy; D016031:Liver Transplantation / Q000379:methods*; D012306:Risk; D014019:Tissue Donors
D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D007136:Immunoglobulins; D019259:Lamivudine
Hepatitis B; Hepatitis B positive graft; Hepatitis B surface antigen positive donor; Liver transplantation; Marginal grafts
Clin Transplant. 2010 Nov-Dec;24(6):735-46
20438579
J Hepatol. 2014 Oct;61(4):809-15
24824283
Expert Rev Gastroenterol Hepatol. 2016 Jul;10 (7):841-59
26831547
J Hepatol. 2012 Mar;56(3):579-85
22027583
J Hepatol. 2010 Feb;52(2):272-9
20034693
Liver Transpl. 2010 Mar;16(3):300-7
20209589
Semin Liver Dis. 2009 Feb;29(1):3-18
19235656
Nat Rev Gastroenterol Hepatol. 2013 Jul;10(7):434-40
23752825
Liver Transpl. 2005 Aug;11(8):922-8
16035057
Liver Transpl. 2011 Oct;17(10):1236-8
21748846
J Hepatol. 2016 Feb;64(2):433-85
26597456
Transplant Proc. 2013 Jan-Feb;45(1):279-80
23267801
World J Gastroenterol. 2015 Jul 14;21(26):8140-7
26185387
Expert Rev Gastroenterol Hepatol. 2016 Jul;10 (7):827-39
26838962
Hepatol Res. 2011 Sep;41(9):846-52
21883736
Transplantation. 1994 Jul 15;58(1):114-6
8036699
Am J Transplant. 2015 Nov;15(11):3013
26372744
Am J Gastroenterol. 2013 Jun;108(6):942-8
23629601
Liver Transpl. 2014 Jan;20(1):35-45
24142889
Gastroenterology. 2010 Aug;139(2):483-90
20451520
Liver Transpl. 2006 Jun;12(6):993-7
16721765
Liver Int. 2007 Nov;27(9):1282-6
17919241
Hepatology. 2014 Mar;59(3):1144-65
24716201
Ann Hepatol. 2011 Jul-Sep;10(3):355-60
21677340
Am J Transplant. 2015 May;15(5):1162-72
25707744
J Hepatol. 2009 Mar;50(3):625-30
19157623
HPB (Oxford). 2004;6(2):88-94
18333056
Gastroenterology. 2011 Oct;141(4):1249-53
21726509
Exp Clin Transplant. 2013 Jun;11(3):245-9
23176583
Ann Transplant. 2015 Feb 23;20:103-11
25703063
Transplantation. 2006 Jan 15;81(1):129-31
16421489
Ann Surg. 2012 Oct;256(4):624-33
22964732
Minerva Gastroenterol Dietol. 2014 Jun;60(2):113-8
24780945
Transpl Int. 2013 Dec;26(12 ):1173-83
24131436
Clin Transplant. 2011 May-Jun;25(3):E243-9
21323735