Effect of prior hepatitis B virus exposure on long-term risk of liver-related events after liver transplantation

• Published in: Clinical transplantation Vol. 30; no. 5; pp. 579 - 588
• Main Authors: Chen, Po-Hung, Limketkai, Berkeley N., Trilianos, Panagiotis, Pirtini-Cetingul, Muge, Woreta, Tinsay A., Kim, Brian, Gulsen, Murat T., Segev, Dorry L., Cameron, Andrew M., Gurakar, Ahmet
• Format: Journal Article
• Language: English
• Published: Denmark Blackwell Publishing Ltd 01-05-2016
• Subjects: Adult; Aged; Female; Follow-Up Studies; Graft Rejection - etiology; Graft Survival; hepatitis B; Hepatitis B - transmission; Hepatitis B - virology; Hepatitis B Antibodies - immunology; Hepatitis B virus; Hepatitis B virus - immunology; Hepatitis C virus; Humans; Liver Cirrhosis - etiology; liver transplantation; Liver Transplantation - adverse effects; Male; Middle Aged; mortality; Postoperative Complications; Prognosis; Retrospective Studies; Risk Factors; Young Adult; graft survival; mortality; hepatitis B; liver transplantation
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/ctr.12723

Objective
To characterize the risk of liver‐related events and death in hepatitis B virus (HBV)‐exposed liver transplantation (LT) recipients.
Methods
Retrospective review was performed in all adults who underwent LT between January 1995 through December 2010 at the Johns Hopkins Hospital. Recipients with graft failure or death within 14 d of LT or missing HBV status were excluded, leaving 575 individuals for analysis. Patients were classified according to HBV exposure status: Unexposed, Resolved HBV, Chronic HBV, or hepatitis B core antibody (anti‐HBc) seropositive liver donor.
Results
Compared with HBV‐unexposed patients, the relative hazard of combined liver‐related events (rejection, cirrhosis, re‐transplantation) and death after LT was not increased in patients with a baseline history of resolved HBV infection or chronic hepatitis B. Using anti‐HBc seropositive donors also did not increase the risk of liver‐related events, death, or composite events (all p ≥ 0.05). However, hepatitis C was associated with liver‐related events [adjusted hazard ratio (aHR), 1.59; 95% confidence interval (CI), 1.00–2.52], and blacks had a higher risk of death (aHR, 1.50; 95% CI, 1.01–2.22).
Conclusion
LT of patients with prior HBV exposure or use of anti‐HBc seropositive donors is not associated with increased risk of liver‐related events or death.