TY - JOUR
T1 - Hepatitis B prophylaxis in hepatitis B-negative recipients transplanted with donor grafts positive for hepatitis B core antibodies
AU - Scuderi, V.
AU - Ceriello, A.
AU - Santaniello, W.
AU - Aragiusto, G.
AU - Romano, M.
AU - Migliaccio, C.
AU - Calise, F.
PY - 2011/1
Y1 - 2011/1
N2 - Background and aims. Use of grafts from hepatitis B (HBV) core antibody (HBcAb+) individuals is a routine transplant practice. Herein, we have reported the results of 20 HBV-negative patients transplantated with a HBcAb-positive liver grafts in order to access the efficacy of HBV prophylaxis using immunoglobulin (IE) and antiviral drugs. Methods. From January 2004 to December 2009, we performed 168 liver transplantations including 38 HBcAb-positive grafts (22.6%) in 18 cases of HBV-positive recipients and 20 HBV-negative recipients. Histological data obtained from these last 20 grafts during retrieval showed an Ishak 1 score in three and no fibrosis in the other cases. HBV prophylaxis included infusion of 10,000 UI IG during the anhepatic phase and every 24 hours for the first 7 days irrespective of the antibody titer as well as lamivudin (100 mg) administred daily. Once discharged, outpatient management provided modulated IG infusions according to when the antibody titer was lower than 400 UI. Results. No patient displayed an HBV infection. The overall survival was 80%. Two patients died within the first month after transplantation due to septic complications; one patient succumbed at 24 months after transplantation because of a lymphoproliferative malignancy and another died due to an aggressive hepatitis C virus recurrence at 6 months post transplant. Conclusion. By using appropriate anti-HBV prophylaxis, HBcAb-positive grafts can be used safely for HBcAb-negative recipients.
AB - Background and aims. Use of grafts from hepatitis B (HBV) core antibody (HBcAb+) individuals is a routine transplant practice. Herein, we have reported the results of 20 HBV-negative patients transplantated with a HBcAb-positive liver grafts in order to access the efficacy of HBV prophylaxis using immunoglobulin (IE) and antiviral drugs. Methods. From January 2004 to December 2009, we performed 168 liver transplantations including 38 HBcAb-positive grafts (22.6%) in 18 cases of HBV-positive recipients and 20 HBV-negative recipients. Histological data obtained from these last 20 grafts during retrieval showed an Ishak 1 score in three and no fibrosis in the other cases. HBV prophylaxis included infusion of 10,000 UI IG during the anhepatic phase and every 24 hours for the first 7 days irrespective of the antibody titer as well as lamivudin (100 mg) administred daily. Once discharged, outpatient management provided modulated IG infusions according to when the antibody titer was lower than 400 UI. Results. No patient displayed an HBV infection. The overall survival was 80%. Two patients died within the first month after transplantation due to septic complications; one patient succumbed at 24 months after transplantation because of a lymphoproliferative malignancy and another died due to an aggressive hepatitis C virus recurrence at 6 months post transplant. Conclusion. By using appropriate anti-HBV prophylaxis, HBcAb-positive grafts can be used safely for HBcAb-negative recipients.
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U2 - 10.1016/j.transproceed.2010.09.100
DO - 10.1016/j.transproceed.2010.09.100
M3 - Article
C2 - 21335203
AN - SCOPUS:79951807192
VL - 43
SP - 271
EP - 273
JO - Transplantation Proceedings
JF - Transplantation Proceedings
SN - 0041-1345
IS - 1
ER -