Kidney transplantation from anti-HBc+ donors: Results from a retrospective Italian study

Tullia M. De Feo, Paolo Grossi, Francesca Poli, Fulvio Mozzi, Piergiorgio Messa, Enrico Minetti, Silvio Sandrini, Luigi Boschiero, Paolo Rigotti, Cristina Maresca, Davide Rolla, Stefano Chiaramonte, Eliana Gotti, Rossana Caldara, Giulio Briano, Mario Scalamogna

Research output: Contribution to journalArticlepeer-review

Abstract

Background. The risk of transmitting a hepatitis B virus (HBV) infection from donor kidneys with a past HBV serological profile may be negligible. Data on HBV transmission to kidney transplant recipients from donor organs that were anti-HBc+/HBsAg- in Italy has not been previously reported. Anti-HBc testing in cadaver organ donors has been mandatory in Italy since 2002, when anti-HBc determinations were included in the National Guidelines for donor evaluation. Therefore, prior to that date kidney recipients from anti-HBc+/HBsAg- donors can be identified retrospectively where stored serum is available for testing. Methods. The prevalence of anti-HBc+ Italian organ donors, the incidence of HBV transmission according to the recipients' HBV status (vaccinated, recovered, or naive), and the clinical impact (5-year graft and patient survival rates) in the North Italy Transplant program was evaluated by retrospectively screening for anti-HBc antibodies in the sera of cadaver kidney donors used in transplants from 1997 to 1999. Results. Two hundred and ten donors were found to have been anti-HBc+. At the time of the study, no active infection was observed in any of the 344 HBsAg- recipients, but 4/140 (2.86%) of the vaccinated recipients were found to have been anti-HBc+/HBsAg -. None of these patients, however, had any biochemical or clinical history of HBV infection. Patient and graft survival rates of anti-HBc + or anti-HBc- kidney recipients did not differ statistically. Conclusion. Kidney grafts from anti-HBc+ donors should be considered in all recipients because the benefit obtained from the transplantation outweighs the negligible risk of HBV transmission.

Original languageEnglish
Pages (from-to)76-80
Number of pages5
JournalTransplantation
Volume81
Issue number1
DOIs
Publication statusPublished - Jan 2006

Keywords

  • Anti-HBc donors
  • HBV transmission
  • Kidney transplantation
  • Transplantation

ASJC Scopus subject areas

  • Transplantation
  • Immunology

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