Transplanting kidneys from donors with prior hepatitis B infection: One response to the organ shortage

Fabrizio Fabrizi, Suphamai Bunnapradist, Paul Martin

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

While the number of cadaveric organ donors remains relatively stable, the number of patients awaiting transplantation continues to increase, creating a shortage of donor organs. To address this imbalance, there is interest in transplanting organs formerly considered marginal or undesirable. Thus, more organs are currently transplanted from living donors, older donors, hemodynamically unstable donors, non-heart-beating donors and donors with markers of prior hepatitis B virus (HBV) infection. A large number (up to 93.8%) of liver transplant seronegative recipients from anti-HBc antibody positive donors have acquired HBsAg after liver transplantation in the absence of immunoprophylaxis. Based on experience in liver transplantation programs, transmission of HBV from donors without HBsAg but with antibody to HBV core antigen (anti-HBc), although conventionally defined as evidence of resolved infection, can have adverse consequences on both graft and recipient. On the contrary, HBV appears to be infrequently transmitted from HBsAg negative/anti-HBcAb positive kidney donors: the incidence of de novo HBsAg seropositivity after renal transplantation ranges between 0 and 5.2%. A significantly higher incidence of anti-HBc antibody seroconversion (without developing HBsAg) after renal transplantation with anti-HBc antibody positive donors was seen. However, anti-HBc antibody positive renal allografts should be considered, especially for recipients who have been successfully immunized with HBV vaccine. Prospective long-term studies are in progress to assess the risk of de novo HBV infection (HBsAg seroconversion) in renal transplant recipients who have not been successfully immunized with vaccine against HBV.

Original languageEnglish
Pages (from-to)605-613
Number of pages9
JournalJournal of Nephrology
Volume15
Issue number6
StatePublished - Nov 1 2002
Externally publishedYes

Fingerprint

Hepatitis B
Tissue Donors
Kidney
Hepatitis B Surface Antigens
Hepatitis B virus
Antibodies
Infection
Antigens
Virus Diseases
Liver Transplantation
Kidney Transplantation
Hepatitis B Core Antigens
Hepatitis B Vaccines
Living Donors
Incidence
Allografts
Vaccines
Transplantation
Transplants
Liver

Keywords

  • Antibody against core antigen
  • Hepatitis B virus infection
  • Renal transplantation

ASJC Scopus subject areas

  • Nephrology

Cite this

Transplanting kidneys from donors with prior hepatitis B infection : One response to the organ shortage. / Fabrizi, Fabrizio; Bunnapradist, Suphamai; Martin, Paul.

In: Journal of Nephrology, Vol. 15, No. 6, 01.11.2002, p. 605-613.

Research output: Contribution to journalArticle

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