Liver transplantation from hepatitis B surface antigen positive donors: A safe way to expand the donor pool

Elisabetta Loggi, Lorenzo Micco, Giorgio Ercolani, Alessandro Cucchetti, Florian K. Bihl, Gian Luca Grazi, Stefano Gitto, Andrea Bontadini, Mauro Bernardi, Paolo Grossi, Alessandro Nanni Costa, Antonio Daniele Pinna, Christian Brander, Pietro Andreone

Research output: Contribution to journalArticlepeer-review


Background & Aims: The main limitation of orthotopic liver transplantation (OLT) is the scarcity of available donor organs. A possibility to increase the organ pool is to use grafts from hepatitis B virus surface antigen (HBsAg) positive donors, but few data are currently available in this setting. We assessed the clinical, serovirological, and immunological outcomes of liver transplant from HBsAg positive donors in a single centre study. Methods: From 2005 to 2009 10 patients underwent OLT from HBsAg positive donors, for HBV-related disease (n = 6) or HBV-unrelated disease (n = 4). The median follow-up was 42 months (range 12-60). All recipients were HBcAb positive and were given antiviral prophylaxis. Results: Patients transplanted for HBV-related disease never cleared HBsAg. Two HBsAg negative patients never tested positive for HBsAg, whereas the others experienced an HBsAg appearance, followed by spontaneous production of anti-HBs, allowing HBsAg clearance. No patient ever had any sign of HBV hepatitis. HBV replication was effectively controlled by antiviral therapy. The immunologic sub-study showed that a most robust anti-HBV specific T cell response was associated with the control of HBV infection. Conclusions: OLT from HBsAg positive donors seems to be a safe procedure in the era of highly effective antiviral therapy.

Original languageEnglish
Pages (from-to)579-585
Number of pages7
JournalJournal of Hepatology
Issue number3
Publication statusPublished - Mar 2012


  • Hepatitis B surface antigen-positive donor
  • Hepatitis B virus (HBV)
  • Immune response
  • Liver transplantation
  • Marginal graft

ASJC Scopus subject areas

  • Hepatology


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