Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (18): 3367-3370.doi: 10.3969/j.issn.1673-8225.2011.18.034

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Application of liver grafts from anti-hepatitis B core positive donors

Lu Hao-ran1, Cai Qiu-cheng2, Lü Li-zhi2, Chen Shao-hua2, Jiang Yi2   

  1. 1Anhui Medical University, Hefei  230032, Anhui Province, China
    2Center of Liver and Gallbladder Diseases, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA, Fuzhou  350002, Fujian Province, China
  • Received:2010-12-08 Revised:2011-01-11 Online:2011-04-30 Published:2011-04-30
  • Contact: Jiang Yi, Chief physician, Doctoral supervisor, Center of Liver and Gallbladder Diseases, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA, Fuzhou 350002, Fujian Province, China aylhr@163.com
  • About author:Lu Hao-ran★, Studying for master’s degree, Anhui Medical University, Hefei 230032, Anhui Province, China aylhr@163.com
  • Supported by:

    Eleventh-Five-year plan of Science and Technology Plan in Nanjing Military Area Command, No.06Z46*

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Abstract:

BACKGROUND: Utilization of anti-HBc positive liver anti-HBc positive graft relieves organ shortage despite it increases risk of hepatitis B virus (HBV) recurrence after liver transplantation.
OBJECTIVE: To evaluate the risk of HBV infection after liver transplantation with anti-HBc positive donors and anti-HBV prophylaxis.
METHODS: The PubMed database was researched using a computer for articles published from January 1994 to December 2009 using the key words of “hepatitis B core antibody; donor; liver transplantation” in English. We performed a literature review over the last 15 years identifying 39 studies including 903 recipients of anti-HBc positive liver grafts.
RESULTS AND CONCLUSION: Recurrent HBV infection developed in 11% of HBsAg-positive liver transplant recipients of anti-HBc positive grafts, while survival was similar (67%–100%) to HBsAg-positive recipients of anti-HBc negative grafts. Neonatal HBV infection developed in 19% of HBsAg-negative recipients being less frequent in anti-HBc/anti-HBs positive than HBV negative cases without prophylaxis (15% vs. 48%). Anti-HBV prophylaxis reduced neonatal infection rates in both anti-HBc/anti-HBs positive (3%) and HBV naive recipients (12%). Neonatal infection rates were 19%, 2.6% and 2.8% in HBsAg-negative recipients under hepatitis B immune-globulin, lamivudine and their combination, respectively. Liver grafts from anti-HBc positive donors can be safely used, preferentially in HBsAg-positive or anti-HBc/anti-HBs positive recipients. HBsAg-negative recipients should receive prophylaxis with lamivudine.

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