Abstract
Liver allografts from donors previously exposed to hepatitis B virus (HBV) carry the risk of transmission of HBV infection to immunosuppressed recipients. However, exclusion of donor candidates with the serologic evidence of resolved hepatitis B—HBV surface antigen (HbsAg) negative and HBV core antibody (anti-HBc) positive—is not feasible in countries endemic for HBV. Aim Our aim was to assess the safety of living donor liver transplantation from anti-HBc positive donors. Materials and Methods In our institution, 152 transplants were performed between June 1999 and April 2004. Fifty-six (37%) of the living donors were anti-HBc positive. Twenty of these liver grafts were transplanted to HbsAg-negative recipients. We excluded four HBsAg negative recipients who died because of early complications after transplantation. Lamivudine (100 mg/day) was given for prophylaxis of de novo HBV infection. Results The mean follow-up time for 16 HBsAg-negative recipients was 21.7 (7–48) months. None of them experienced de novo HBV infection. Conclusion The use of liver allografts from anti-HBc-positive living donors is reasonably safe in HBsAg-negative recipients under lamivudine prophylaxis.
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