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Hepatitis B in Heart Transplant Donors and Recipients: A Systematic Review and Meta-Analysis
Colin C Yost1, Diana C Jimenez1, Matthew P Weber1
1Division of Cardiac Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
The Journal of Surgical Research
|March 14, 2023
Summary
Using hepatitis B virus (HBV) positive donors for heart transplants (D+/R-) is safe and effective. This approach reduces active HBV infections and mortality compared to using HBV negative donors (D-/R+), with similar survival rates.
Area of Science:
- Cardiology
- Hepatology
- Transplantation Immunology
Background:
- The shortage of donor organs for heart transplantation is a significant clinical challenge.
- Utilizing organs from hepatitis B virus (HBV) positive donors could expand the donor pool.
- Evaluating the safety and efficacy of HBV donor heart transplantation is crucial.
Approach:
- A systematic review and meta-analysis was conducted.
- Studies involving heart transplants with HBV positive donors and/or recipients were identified.
- Outcomes were compared between D+/R- (HBV positive donor, HBV negative recipient) and D-/R+ (HBV negative donor, HBV positive recipient) groups.
Key Points:
- 163 patients from 13 studies were analyzed.
- Active post-transplant HBV infection occurred in 11% of D+/R- recipients versus 33% of D-/R+ recipients.
- Hepatitis-related mortality was 0% in D+/R- recipients and 7% in D-/R+ recipients.
- One-year post-transplant survival was comparable (83% for D+/R- vs. 81% for D-/R+).
Conclusions:
- HBV D+/R- heart transplantation is associated with lower rates of active hepatitis B infection and reduced hepatitis-related mortality compared to D-/R+ transplantation.
- One-year survival rates are comparable between the two groups.
- Further research using HBV nucleic acid testing is needed to fully assess donor-derived infection risks.
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