Safe use of hepatitis B surface antigenpositive grafts in liver transplantation:A nationwide study based on the KOTRY data
- Author:
Sujin GANG
1
;
YoungRok CHOI
;
Kwang-Woong LEE
;
Bong-Wan KIM
;
Dong-Sik KIM
;
Yang Won NAH
;
Jongman KIM
;
Jae Geun LEE
;
Je Ho RYU
;
Jaehong JEONG
;
Geun HONG
Author Information
- Publication Type:Original Article
- From: Annals of Liver Transplantation 2026;6(1):41-55
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:In the era of nucleoside analogs (NA), we investigated the safety of using hepatitis B surface antigen (HBsAg)-positive grafts in liver transplantation (LT) using nationwide KOTRY data.
Methods:Among 4,265 adult LTs in the KOTRY registry (April 2014–January 2020), 20 (0.5%) used HBsAg(+) grafts. The S(+) group was compared with HBsAg-nega-tive groups, both HBcAb(+) (C[+]) and HBcAb(−) (SC[−]), using 1:1 propensity scorematching. Patient and graft survival were evaluated using Kaplan–Meier analysis.Cox regression was used to identify prognostic factors.
Results:No significant differences were observed in patient or graft survival be-tween S(+) and C(+) or SC(−) groups. Key prognostic factors for patient survivalincluded age, HCC, MELD score, ascites, and encephalopathy. For graft survival, HCC, preoperative HCC treatment, MELD score, ascites, and encephalopathy were significant. HBV recurrence occurred in the S(+) group, but did not compromise outcomes.
Conclusion:In HBV-endemic regions, HBsAg(+) liver grafts can be safely used to expand the donor pool without compromising LT outcomes when combined with appropriate prophylaxis.
