Results of Use of Hepatitis B Core Antibody-Positive Donors in Living Donor Liver Transplantation with Passive Immunoprophylaxis.
- Author:
Dong Lak CHOI
1
;
Sung Gyu LEE
;
Young Joo LEE
;
Kwang Min PARK
;
Shin HWANG
;
Ki Hun KIM
;
Choong Hyeon NAM
;
Chul Soo AHN
;
Jae Han JEONG
;
Pyung Chul MIN
Author Information
1. Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Hepatitis B Core Antibody-Positive [HBcAb(+)];
Living Donor Liver transplantation Passive immunoprophylaxis
- MeSH:
Cadaver;
Chungcheongnam-do;
Hepatitis B*;
Hepatitis*;
Herpesvirus 1, Cercopithecine;
Humans;
Korea;
Liver Transplantation*;
Liver*;
Living Donors*;
Prevalence;
Tissue Donors*;
Transplants
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
1999;3(2):25-31
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: In Korea, the number of patients enrolled in liver transplantation registry exceeds the supply of cadaveric donor. This donor shortage leads to living donor liver transplantation(LDLT). Due to wide prevalence of hepatitis B in Korea, many healthy donors for LDLT shows hepatitis B surface antigen-negative[HBsAg(-)] and core antibody-positive [HBcAb(+)]. However, the risk of using graft livers from HBsAg(-) and HBcAb(+) donors has not been clearly defined. The aim of this study is to identify the safety of using HBcAb(+) donor and the effectiveness of passive immunoprophylaxis with hepatitis B immunoglobulin(HBIG) in non-hepatitis B virus induced cirrhotic recipients. METHODS: From December 1994 to July 1998, 59 patients underwent living donor liver transplantation at the Asan Medical Center. Among them, 35 cases were non-hepatitis B virus induced cirrhotic recipients. Of these 35 recipients, 14 patients received liver graft from HBsAg(-) and HBcAb(+) donors and prophylactic passive immunoprophylaxis with HBIG. RESULTS: Eleven cases remained HBsAg(-) with HBIG immunoprophylaxis. Three of 14 recipients who were HBsAg(-) converted to HBsAg(+) serologically after receiving HBcAb(+) donor liver. All of these 3 cases did not receive HBIG therapy. CONCLUSIONS: Passive immunoprophylaxis with HBIG may prevent non-hepatitis B induced cirrhotic recipients from converting to HBsAg(+) status by using HBcAb(+) donor. Our experience suggests that HBcAb(+) donors can be accepted as potential donors in living donor liver transplantation.
