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Hepatitis B-core antibody positive donors in liver transplantation and graft survival

A study in this month's Journal of Hepatology examines Hepatitis B-core antibody positive donors in liver transplantation and their impact on graft survival.

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Dr Mario Angelico from Italy evaluated Hepatitis B-core antibody positive donors in liver transplantation and their impact on graft survival within Liver Match, a prospective observational Italian study.

Data from 1437 consecutive, first transplants performed in 2007–2009 using grafts from deceased heart beating donors were analyzed.

Of these, 219 were HBcAb positive.

The team report that 66 HBcAb positive grafts were allocated to HBsAg positive, and 153 to HBsAg negative recipients.

The team noted that 329 graft losses occurred, including 66 among 219 recipients of HBcAb positive grafts, and 263 among 1218 recipients of HBcAb negative grafts.

The researchers assessed that graft survival was lower in recipients of HBcAb positive compared to HBcAb negative donors, with unadjusted 3-year graft survival of 0.69 and 0.77, respectively.

Graft loss due to de novo HBV hepatitis occurred only in 1 patient
Journal of Hepatology

After stratifying for recipient HBsAg status, this difference was only observed among HBsAg negative recipients, 3-year graft survival being excellent among HBsAg positive recipients, regardless of the HBcAb donor status.

The team of doctors observed that graft loss due to de novo HBV hepatitis occurred only in 1 patient.

At Cox regression, hazard ratios for graft loss included MELD, donor HBcAb positivity, recipient HBsAg positivity, portal vein thrombosis, and DRI.

Dr Angelico's team commented "HBcAb positive donor grafts have better outcomes when transplanted into HBsAg positive than HBsAg negative recipients."

"These findings suggest that donor HBcAb positivity requires more stringent allocation strategies."

J Hepatol 2013: 58(4): 715-723
19 April 2013

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