De novo hepatitis B virus infection from anti-HBc-positive donors in pediatric living donor liver transplantation and the treatment
10.3760/cma.j.issn.0254-1785.2015.02.007
- VernacularTitle:乙型肝炎核心抗体阳性亲属活体供肝应用于儿童受者的风险及治疗方案
- Author:
Chong DONG
;
Wei GAO
;
Nan MA
;
Chao SUN
;
Shanli LI
;
Kai WANG
;
Zhongyang SHEN
- Publication Type:Journal Article
- Keywords:
Liver transplantation;
Child;
Living donor;
Hepatitis B virus
- From:
Chinese Journal of Organ Transplantation
2015;36(2):92-96
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the incidence and risk factors of de novo hepatitis B virus (HBV) infection from anti-HBc-positive donors in pediatric living donor liver transplantation and to explore the diagnosis and treatment.Method A retrospective analysis was conducted on 105 cases of pediatric living donor liver transplantaions (LT) perfomed during September 2006 to December 2013.HBV markers,including hepatitis B surface antigen (HBsAg) and antibody (anti-HBs),anti-HBc,hepatitis B e antigen (HBeAg) and antibody (anti-HBe) were determined in both donors and recipients before LT and in recipients after LT.HBV DNA titer was measured if the recipients were strongly suspected of de novo HBV infection.Result After 4 perioperative deaths were excluded,101 cases were studied.The median follow-up period of all the patients was 20.5 months (2.7-97.7 months).de novo HBV infection occurred in 6 of 101 recipients (5.9％) 3.5 18 months after LT.Forty-four (43.6％) of the children received HBcAb-positive allografts,and 11.4％ (5/44) of the children were had de novo hepatitis B infection.All five of the HBV-infected children received HBcAb-positive allografts without preventive treatment in 11 cases (5/11,45.5 ％),57 (56.4％) of the children received HBcAb-negtive allografts,and 1.7％ (1/57) of the children had de novo hepatitis B infection.Conclusion Anti-HBc-positive donors can significantly increase the incidence of de novo HBV infection in HBsAg-negative recipients without preventive treatment.with the appropriate treatment strategy,HBcAb allografts can safely used in pediatric recipients.
