[A study of the efficacy and safety of using hepatitis B surface antigen-positive donors for liver transplantation]

Zhonghua Gan Zang Bing Za Zhi. 2012 Jan;20(1):14-6. doi: 10.3760/cma.j.issn.1007-3418.2012.01.006.
[Article in Chinese]

Abstract

Objective: To evaluate the outcomes of liver transplant recipients who received liver allografts from hepatitis B surface antigen (HBsAg)-positive donors.

Methods: The medical records of 23 male patients (median age, 42.5 years; range: 29-61) who received HBsAg-(+) liver allografts in our organ transplant center were retrospectively analyzed. All patients had confirmed diagnosis of end-stage liver disease (ESLD) secondary to hepatitis B virus (HBV) infection, including 13 HBsAg(+)/HBeAg(-)/HBcAb(+) cases and 10 HBsAg(+)/HBeAb(+)/HBcAb(+) cases. After transplantation, all patients were administered oral entecavir and intravenous anti-hepatitis B immunoglobulin (HBIG) (2000 IU/d during the first week), along with a steroid-free immune suppression regimen. HBV-related antigen and antibody and HBV DNA were detected on post-transplantation days 1, 7, 14, 21, and 30. The liver allografts were monitored by ultrasound imaging. After discharge, monthly follow-up recorded liver function, renal function, acute rejection, infections, vascular complications, biliary complications, HBV recurrence, cancer recurrence, and patient survival.

Results: Two of the recipients died from severe perioperative pneumonia. The remaining 21 recipients were followed-up for 10 to 38 months, and all 21 patients remained HBsAg(+). One recipient developed biliary ischemia and required a second liver transplantation at five months after the primary transplantation. Three recipients (all primary) died from tumor recurrence at 9, 14, and 18 months post-transplantation, respectively. All other recipients survived and had acceptably low HBV DNA copy levels. Color Doppler imaging showed good graft function and normal texture. The patient and graft survival rates were 78.3% (18/23) and 73.9% (17/23), respectively. The recurrence rate of HBV infection was 100% (23/23). In surviving patients, no liver function abnormality, graft loss, or death was found to be related to the recurrence of HBV infection.

Conclusion: Liver transplantation using HBsAg(+) liver grafts was safe for patients with ESLD secondary to HBV infection.

Publication types

  • English Abstract
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • End Stage Liver Disease / surgery*
  • End Stage Liver Disease / virology
  • Hepatitis B Surface Antigens / immunology*
  • Humans
  • Liver Transplantation / immunology*
  • Liver Transplantation / methods*
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Tissue Donors

Substances

  • Hepatitis B Surface Antigens