Ask the Expert

I work in a high prevalence area of Hepatitis B and a lot of potential deceased donors are Hepatitis B core anitbody positive. We have always declined these patients as liver donors, but accepted their kidneys. Is it an option to use these livers?
Topics: livertransplantation
Answered by Kimberly Ann Brown on August 24 2010 | Permalink
Grafts from donors with antibodies against HBV cor antigen (anti-HBc) but HBsAg negative are common in areas with intermediate to high prevalence of HBV infection. Several studies have shown that these organs can transmit Hepatitis B to HBsAg negative recipients. Accurate estimates of transmission risk are difficult to come by. Several authors suggest that recipients who are HBsAb positive (either naturally or through vaccination) have very low risk of transmission. In addition, there are data to support the use of these organs especially in the setting of antiviral therapy post transplantation either with HBIG or oral agents. As such, many centers do consider these organs particularly for those recipients who are HBsAb positive. As newer agents such as Entecavir and Tenofovir are used post transplantation, the risk of transmission from donor to recipient would be anticipated to decline further. A very nice review of this subject with complete review of the literature can be found: Cholongitas E, et al. Journal of Hepatology 2010, volume 52: pp 272-279.
-Kimberly Ann Brown
Disclosure Statement
Nothing contained in this web site is to be considered as the rendering of medical, professional or other advice for specific cases. Users are responsible for obtaining such advice from their own sources. The information contained on this site is intended for educational, background and informational purposes only.