Long-term patient and renal allograft survival in HBsAg infection: a recent update

Although the risk of HBsAg infection has now been reduced significantly by screening of blood, isolation of HBsAg+ patients, and more recently by vaccination, transplant-eligible patients can still be seen. We observed an increased mortality in HBsAg+ patients during 5 to 10 years posttransplantation. However, this could not be attributed to liver disease or dysfunction. Increased mortality and morbidity due to liver disease or dysfunction 10 years posttransplantation suggest that the HBsAg+ patients remain at a higher risk for developing liver disease during that period. In our study, HBsAg+ patients had a 10-year posttransplantation period relatively free of serious liver disease or dysfunction. Furthermore, both HBsAg+ and HBsAg- patients had a similar long-term allograft survival. It is unknown how the use of cyclosporine will affect those survival statistics. We, therefore, believe that HBsAg positivity per se should not constitute an absolute contraindication to transplantation.