Anti-HBs re-seroconversion after liver transplantation in a patient with past HBV infection receiving a HBsAg positive graft

Elisabetta Loggi, Florian Bihl, John V. Chisholm, Maurizio Biselli, Andrea Bontadini, Giovanni Vitale, Giorgio Ercolani, Gian Luca Grazi, Antonio D. Pinna, Mauro Bernardi, Christian Brander, Pietro Andreone

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aims: Orthotopic liver transplantation (OLT) is an important therapeutic option for HBV-related end-stage-liver disease, yet it is often hampered by a scarcity of organ availability. One option to increase organ availability is the use of virologically compromised organs from HBV-infected donors. Transplantation of anti-HBcore positive grafts has been associated with a low risk of HBV recurrence if adequately treated with nucleoside analogs, irrespective of concomitant HBV-specific immunoglobulin therapy. Experience using HBsAg positive grafts is, however, very limited. Methods: Here, the analysis of the cellular and humoral HBV-specific immunity of a subject with past HBV infection (anti-HBs and anti-HBc positive) receiving an HBsAg positive liver graft is reported. Results: Nine months post-OLT, the patient experienced a spontaneous anti-HBs re-seroconversion allowing the discontinuation of HBIG. The data show a concurrent increase in the cellular and humoral immunity at times of reduced viral antigenemia, demonstrating effective immune control of HBV post-OLT. Conclusions: These data support the use of marginal organs in this setting, providing a potential strategy to further alleviate organ shortage.

Original languageEnglish
Pages (from-to)625-630
Number of pages6
JournalJournal of Hepatology
Volume50
Issue number3
DOIs
Publication statusPublished - Mar 2009

Keywords

  • HBsAg positive marginal graft
  • Humoral immunity
  • Organ shortage
  • Orthotopic liver transplantation
  • T cell immunity

ASJC Scopus subject areas

  • Hepatology

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