Hepatitis B in Solid-Organ Transplant Procedures Other Than Liver

Area of Science:

• Transplant Surgery
• Hepatology
• Infectious Diseases

Background:

• Hepatitis B virus (HBV) infection is a major cause of morbidity and mortality in non-liver transplant recipients.
• HBV can lead to severe hepatic complications, including fibrosing cholestatic hepatitis and histologic deterioration post-transplant.

Purpose of the Study:

• To outline the risks of HBV infection in non-liver transplant patients.
• To recommend strategies for preventing and managing HBV-related complications in transplant recipients.

Main Methods:

• Systematic use of nucleoside or nucleotide analogues (tenofovir or entecavir preferred) before or during transplant.
• Consideration of decompensated cirrhosis as a contraindication for non-liver transplant but an indication for combined liver-kidney transplant.
• Evaluation of HBV status in organ donors and recipients for allocation and prevention strategies.

Main Results:

• Sustained viral suppression through antiviral therapy can lead to fibrosis regression.
• This regression may decrease disease-related morbidity and improve post-transplant survival.
• HBV status is critical for organ allocation decisions.

Conclusions:

• Prophylactic antiviral therapy is recommended for all non-liver transplant recipients to prevent HBV complications.
• Chronic hepatitis B with decompensated cirrhosis necessitates careful consideration regarding transplant type.
• Vaccination and appropriate donor-recipient matching are key preventive measures against HBV in transplantation.