The Effect of HBsAg-Positivity of Kidney Donors on Long-Term Patient and Graft Outcome

The Effect of HBsAg-Positivity of Kidney Donors on Long-Term Patient and Graft Outcome

The number of patients on the kidney waiting list is increasing, creating a shortage of donor organs. To solve this problem, there is an interest in transplanting organs formerly considered marginal or undesirable. We performed seven (four living related, three cadaveric) kidney transplants from hep...

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Bibliographic Details
Published in:Transplantation proceedings Vol. 37; no. 10; pp. 4173 - 4175
Main Authors: Berber, I., Aydin, C., Yigit, B., Turkmen, F., Titiz, I.M., Altaca, G.
Format: Journal Article
Language:English
Published: New York, NY Elsevier Inc 01-12-2005
Elsevier Science
Subjects:
Biological and medical sciences
Cadaver
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Graft Survival - immunology
Hepatitis B e Antigens - analysis
Hepatitis B Surface Antigens - analysis
Hepatitis B virus - isolation & purification
Humans
Kidney Transplantation - immunology
Kidney Transplantation - mortality
Living Donors
Medical sciences
Retrospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Survival Analysis
Tissue Donors
Tissue, organ and graft immunology
Treatment Outcome
Human
Seropositivity
Hepatitis B surface antigen
Prognosis
Orthohepadnavirus
Patient
Transplantation
Long term
Kidney
Virus
Medicine
Treatment
Urinary system
Donor
Hepadnaviridae
Surgery
Evolution
Graft
Hepatitis B virus
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Summary:The number of patients on the kidney waiting list is increasing, creating a shortage of donor organs. To solve this problem, there is an interest in transplanting organs formerly considered marginal or undesirable. We performed seven (four living related, three cadaveric) kidney transplants from hepatitis B surface antigen (HBsAg)-positive donors. Hepatitis B e antigen (HBeAg) and hepatitis B virus (HBV) DNA were negative in the living donors and were unknown in cadaveric donors. Liver function tests were in the normal range in all of the donors. All of the recipients were HBsAg-negative and hepatitis B surface antibody (anti-HBs)-positive. Recipients receiving kidneys from cadaveric donors were given prophylactic lamivudine treatment postoperatively. Anti-HBs remained positive throughout the follow-up period in all but one patient with a cadaveric graft. None of the patients receiving a kidney from an HBsAg-positive donor developed clinical HBV infection in a mean follow-up period of 42.6 ± 36.8 months (range: 16 to 121 months, median 30 months). Liver function tests remained in the normal ranges in all patients. All the grafts are still functioning with a mean serum creatinine level of 1.6 ± 0.85 mg/dL. In conclusion, transplants from HBsAg-positive and HBeAg-/HBV DNA-negative donors seem to carry no risk to the recipients who are immune to HBV. Even cadaveric donors with HBsAg-positivity and unknown HBeAg/HBV DNA status can be used with caution in selected recipients without significantly affecting graft and patient outcome.
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ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2005.10.094