Transplantation of hepatitis B surface antigen positive bone marrow

We considered for bone marrow transplantation a boy whose only histocompatible donor was positive for hepatitis B surface antigen (HBsAg). He was conditioned for transplantation with cyclophosphamide and total body irradiation. Hepatitis hyperimmune gamma globulin was administered following the bone marrow infusion. Fourteen months after transplantation, the recipient remains a chronic HBsAg carrier, but he has neither developed fulminant liver disease nor has there been any evidence of graft failure.