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KMID : 0371420150890030145
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Annals of Surgical Treatment and Research
2015 Volume.89 No. 3 p.145 ~ p.150
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De novo hepatitis B virus infection developing after liver transplantation using a graft positive for hepatitis B core antibody
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Han Jae-Hyun
Kim Dong-Goo
Na Gun-Hyung
Kim Eun-Young
Lee Soo-Ho
Hong Tae-Ho
You Young-Kyoung
Choi Jong-Young
Yoon Seung-Kew
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Abstract
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Purpose: The use of hepatitis B core antibody (HBcAb)-positive grafts is increasing, especially where hepatitis B is endemic. However, this remains controversial because of the risk of development of de novo HBV infection.
Methods: We collected information obtained between January 2000 and December 2012 and retrospectively analyzed data on 187 HBsAg-negative donors and recipients were analyzed retrospectively. De novo HBV infection was defined as development of HBsAg positivity with or without detection of HBV DNA.
Results: Forty patients (21.4%) received HBcAb-positive grafts. Survival rate did not differ by donor HBcAb status (P = 0.466). De novo HBV infection occurred in five patients (12.5%) who were not treated with anti-HBV prophylaxis, and was significantly more prevalent in hepatitis B surface antibody (HBsAb)- and HBcAb-negative than HBsAb- and HBcAb-positive recipients (50% vs. 4.2%, P = 0.049). All patients except one were treated with entecavir with/without antihepatitis B immunoglobulin and four were negative in terms of HBV DNA seroconversion. No patient died.
Conclusion: HBcAb-positive grafts are safe without survival difference. However, the risk of de novo hepatitis B virus infection was significantly increased in HBsAb- and HBcAb-negative recipients. All patients were successfully treated even after recurrence.
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KEYWORD
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Hepatitis B antibodies, de novo hepatitis B, Liver transplantation, Prognosis
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