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23 February 2015 : Original article  

Successful Use of Hepatitis B Surface Antigen-Positive Liver Grafts – An Effective Source for Donor Organs in Endemic Areas: A Single-Center Experience

Long-Bin JengABCDE, Ashok ThoratABCDE, Horng-Ren YangBDE, Chun-Chieh YehBDEF, Te-Hung ChenABF, Chia-Hao HsuABF, Shih-Chao HsuBCF, Kin-Shing PoonDF, Ping-Chung LiBF, Hsueh-Chou LaiABDF, Wen-Pang SuADF, Cheng-Yuan PengABCD

DOI: 10.12659/AOT.893032

Ann Transplant 2015; 20:103-111

Abstract

BACKGROUND: Due to high prevalence of hepatitis B virus (HBV) infection in Taiwan, liver grafts from donors positive for hepatitis B surface antigen (HBsAg) without progressive disease can be effective alternative source of donor organs. This study aims to prove the safety of living donor liver transplantation (LDLT) using HBsAg-positive liver grafts and its long-term outcome.

MATERIAL AND METHODS: We studied 14 consecutive LDLT recipients that received HBsAg-positive grafts from November 2009 to December 2013 for various indications. All donors were chronic HBsAg carriers with normal liver function tests. Median follow-up was 46 months (range, 35–59).

RESULTS: All the donors and recipients recovered well post-transplant with no reactivation of HBV to date. Two of the recipients died due to extra-hepatic recurrence of HCC. At median follow-up of 46 months, 4-year cumulative survival of recipients was 77.38%.

CONCLUSIONS: In endemic areas, HBsAg-positive donor organs can clearly be used effectively under viral immunoprophylaxis. HBV disease reactivation does not appear to be a threat even with hepatitis B immunoglobulin (HBIG)-free antiviral monoprophylaxis regimen. This study thus proves the safety and feasibility of the option of using HBsAg-positive grafts in high-prevalence areas.

Keywords: End stage liver disease, Liver Failure, Acute, Liver Neoplasms

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358