title: Risks and treatment strategies for de novo hepatitis B virus infection from anti-HBc-positive donors in pediatric living donor liver transplantation.
abstract: The aim of this study was to analyze the incidence and risk factors of de novo HBV infection in pediatric patients receiving living donor liver transplants (LDLT) from HBcAb-positive donors, and to explore its treatment strategies. The data of 101 pediatric recipients receiving LDLT in Tianjin First Central Hospital between September 2006 and December 2012 were retrospectively analyzed. The HBV markers were regularly tested before and after the surgery, including HBsAb, HBsAg, HBeAg, HBeAb, and HBcAb. The median follow-up period was 25.6 months, during which eight cases (7.92%) were diagnosed with de novo HBV infection. Forty-four (43.6%) of the children received HBcAb-positive allografts. The rate of de novo HBV in the children that received HBcAb+ livers vs those received HBcAb- livers was 15.9% (7/44) vs 1.7% (1/57) (P=.037). The rates of de novo HBV in the children who received HBcAb-positive allografts were significantly less than in those that received preventative therapy with HBIG and lamivudine treatment (2/31, 6.4%) vs those that did not (5/13, 38.5%) (P<.01). HBcAb-positive liver donors are strongly associated with de novo HBV in HBsAg-negative pediatric patients receiving LDLT. However, the incidence of de novo HBV infection is significantly less with the use of prophylactic treatment strategies.
authors.affiliation: First Central Clinical College, Tianjin Medical University, Tianjin, China.|Transplantation Surgery, Tianjin Key Laboratory of Organ Transplantation, Tianjin First Central Hospital, Tianjin, China.
authors.forename: Chong
authors.initials: C
authors.lastname: Dong
authors.affiliation: First Central Clinical College, Tianjin Medical University, Tianjin, China.|Transplantation Surgery, Tianjin Key Laboratory of Organ Transplantation, Tianjin First Central Hospital, Tianjin, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.affiliation: First Central Clinical College, Tianjin Medical University, Tianjin, China.|Transplantation Surgery, Tianjin Key Laboratory of Organ Transplantation, Tianjin First Central Hospital, Tianjin, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Ma
authors.affiliation: First Central Clinical College, Tianjin Medical University, Tianjin, China.|Transplantation Surgery, Tianjin Key Laboratory of Organ Transplantation, Tianjin First Central Hospital, Tianjin, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Sun
authors.affiliation: Transplantation Surgery, Tianjin Key Laboratory of Organ Transplantation, Tianjin First Central Hospital, Tianjin, China.
authors.forename: Wei-Ping
authors.initials: WP
authors.lastname: Zheng
authors.affiliation: Transplantation Surgery, Tianjin Key Laboratory of Organ Transplantation, Tianjin First Central Hospital, Tianjin, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.affiliation: First Central Clinical College, Tianjin Medical University, Tianjin, China.|Transplantation Surgery, Tianjin Key Laboratory of Organ Transplantation, Tianjin First Central Hospital, Tianjin, China.
authors.forename: Zhong-Yang
authors.initials: ZY
authors.lastname: Shen
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D002648:Child; D002675:Child, Preschool; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000517:prevention & control / Q000821:virology*; D006510:Hepatitis B Antibodies / Q000276:immunology; D006515:Hepatitis B virus; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D007223:Infant; D019259:Lamivudine / Q000627:therapeutic use; D017093:Liver Failure / Q000150:complications* / Q000517:prevention & control / Q000821:virology*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D006510:Hepatitis B Antibodies; D007136:Immunoglobulins; D019259:Lamivudine; C045213:hepatitis B hyperimmune globulin
keywords: HBcAb positive donors; de novo HBV infection; hepatitis B virus; living donor liver transplantation; pediatric liver transplantation