Donors positive for hepatitis B core antibodies in nonliver transplantations

Area of Science:

• Transplantation immunology
• Infectious disease epidemiology
• Hepatitis B virus (HBV) research

Background:

• Increasing organ shortages necessitate the use of hepatitis B core antibody (HBcAb)-positive donors.
• The risk of hepatitis B transmission varies by organ type, influenced by lymphoid tissue content.
• Current registries lack comprehensive data on post-transplant hepatitis B incidence.

Purpose of the Study:

• To evaluate the risk of hepatitis B transmission from HBcAb-positive organ donors.
• To assess the safety and outcomes of using organs from HBcAb-positive donors.
• To review current guidelines for managing recipients of organs from HBcAb-positive donors.

Main Methods:

• Review of epidemiological and cohort data on organ transplantation from HBcAb-positive donors.
• Analysis of graft and patient survival rates.
• Examination of seroconversion rates to hepatitis B surface antigen (HBsAg) in recipients.

Main Results:

• Organs from HBcAb-positive donors can be safely transplanted following established guidelines.
• The incidence of HBcAb-positive donors is approximately 15%-20%.
• One-year graft outcomes are favorable, with a 3% seroconversion rate to HBsAg.

Conclusions:

• Transplantation of organs from HBcAb-positive donors is a viable option to address organ shortages.
• Prophylaxis with lamivudine or hepatitis B immunoglobulin is crucial for recipients lacking HBsAb.
• Adherence to guidelines ensures good graft survival and minimizes hepatitis B transmission risk.