<i><scp>D</scp>e novo</i> hepatitis <scp>B</scp> virus infection from anti‐HBc‐positive donors in pediatric living donor liver transplantation

Zhi, Xi; Xia, Qiang; Zhang, Jian Jun; Chen, Xiao Song; Han, Long Zhi; Zhu, Jian; Wang, Si Yue; Qiu, De Kai

doi:10.1111/1751-2980.12066

Cited by 17 publications

(18 citation statements)

References 28 publications

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“…In another study, 11 of 19 patients who received living donor transplants from anti‐HBc+ donors developed DNH. Eight of the 11 had no evidence of anti‐HBs prior to transplant . Overall, vaccination appeared to be the most consistently employed strategy in pediatric LT recipients who received an anti‐HBc+ organ and was associated with a DNH rate of 15.7%.…”

Section: Introductionmentioning

confidence: 98%

“…Compared to pediatric KT, a relatively larger experience of outcomes after pediatric LT with anti‐HBc+ organs exists. The majority of the reported data comes from Asia with a total of 100 patients and an additional three patients reported from Poland . Except for 19 cases from China, all patients received routine vaccination in infancy and after transplant.…”

Section: Introductionmentioning

confidence: 99%

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Solid Organ Transplantation From Hepatitis B Virus–Positive Donors: Consensus Guidelines for Recipient Management

Huprikar

Danziger‐Isakov

Ahn

et al. 2015

American Journal of Transplantation

202

169

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Use of organs from donors testing positive for hepatitis B virus (HBV) may safely expand the donor pool. The American Society of Transplantation convened a multidisciplinary expert panel that reviewed the existing literature and developed consensus recommendations for recipient management following the use of organs from HBV positive donors. Transmission risk is highest with liver donors and significantly lower with non‐liver (kidney and thoracic) donors. Antiviral prophylaxis significantly reduces the rate of transmission to liver recipients from isolated HBV core antibody positive (anti‐HBc+) donors. Organs from anti‐HBc+ donors should be considered for all adult transplant candidates after an individualized assessment of the risks and benefits and appropriate patient consent. Indefinite antiviral prophylaxis is recommended in liver recipients with no immunity or vaccine immunity but not in liver recipients with natural immunity. Antiviral prophylaxis may be considered for up to 1 year in susceptible non‐liver recipients but is not recommended in immune non‐liver recipients. Although no longer the treatment of choice in patients with chronic HBV, lamivudine remains the most cost‐effective choice for prophylaxis in this setting. Hepatitis B immunoglobulin is not recommended.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Solid Organ Transplantation From Hepatitis B Virus–Positive Donors: Consensus Guidelines for Recipient Management

Huprikar

Danziger‐Isakov

Ahn

et al. 2015

American Journal of Transplantation

202

169

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“…Nevertheless, pediatric patients on the waiting list are mostly free of HBV infection. Previous study had reported that the incidence of de novo HBV infection in pediatric recipients without any prophylactic treatment was about 20% . De novo HBV infection in the pediatric recipients not only influences the graft function and life quality of individuals but also increases the social and economic burden of the nation.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of de novo hepatitis B virus infection in pediatric hepatitis B core antibody positive liver graft recipients under prophylactic therapy

Dong

Song

Chen

et al. 2019

J of Gastro and Hepatol

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Background and Aim:We aim to investigate the risk factors of de novo hepatitis B virus (HBV) infection in pediatric liver transplantation recipients receiving hepatitis B core antibody positive grafts and to evaluate the efficacy of our prophylactic strategies. Methods: One hundred thirty-nine pediatric recipients receiving hepatitis B core antibody positive grafts operated from September 2016 to September 2018 were retrospectively enrolled, and all the patients received prophylactic treatment to prevent de novo HBV infection. Donor and recipient features, operative information along with graft, and recipient outcomes were compared between recipients with or without de novo HBV infection. Univariate and multivariate analyses were applied to identify the risk factors of de novo HBV infection. Results: The mean follow-up time was 23.5 ± 15.7 months, and the overall incidence of de novo HBV infection was 3.6%. Recipients with de novo HBV infection showed equal graft and recipient outcome compared with the recipients without de novo HBV infection during the follow-up time. Recipient preoperative hepatitis B surface antibody titer of < 1000 IU/L (odds ratio [OR] = 9.652, P = 0.024), graft HBV DNA of > 1000 copies (OR = 9.050, P = 0.032), and intraoperative fresh-frozen plasma transfusion of > 400 mL (OR = 10.462, P = 0.023) were identified as independent risk factors for de novo HBV infection. Conclusion: Hepatitis B core antibody positive grafts can safely be used in pediatric liver transplantation under rational prophylactic therapy.

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“…Abdominal sonography was performed every three months during the first two yr and annually thereafter. Serum tests for hepatitis B virus were performed for children who received an anti‐HBc‐positive graft . Because children came from various parts of the country, some of them had these tests performed in local hospitals.…”

Section: Methodsmentioning

confidence: 99%

Influence of graft size matching on outcomes of infantile living donor liver transplantation

Wan

Zhang

et al. 2015

Pediatric Transplantation

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We aimed to assess the impact of size mismatching between grafts and recipients on outcomes of infants or small children after LDLT. Between October 2006 and December 2014, 129 LDLT recipients weighing no more than 8 kg were retrospectively analyzed. The entire cohort was categorized into three groups by GRWR: GRWR < 3.0% (group A, n = 38), 3.0% ≤ GRWR < 4.0% (group B, n = 61), and GRWR ≥ 4.0% (group C, n = 30). Baseline characteristics were similar among groups A, B, and C. Compared with groups A and B, post-transplant alanine aminotransferase and aspartate aminotransferase within seven days were significantly higher in group C; however, differences between total bilirubin and albumin after transplantation were not prominent. Moreover, incidences of surgical complications, perioperative deaths, infections, and acute rejections were all comparable among the three groups. Five-yr patient survival rates for groups A, B, and C were 89.5%, 88.9%, and 81.6%, respectively (p = 0.872), and the graft survival rates were 89.5%, 86.6%, and 81.6%, respectively (p = 0.846). In conclusion, GRWR between 1.9% and 5.8% would not cause noticeable adverse events for infantile LDLT recipients ≤ 8 kg. However, there is still a role for considering reduction in the graft mass as an applicable strategy in selected cases.

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De novo hepatitis B virus infection from anti‐HBc‐positive donors in pediatric living donor liver transplantation

Abstract: Anti-HBc-positive donors can significantly increase the incidence of de novo HBV infection in HBsAg-negative recipients. Administration with adefovir in patients who are resistant to lamivudine seems to be an effective and safe way for de novo HBV infection.

Cited by 17 publications

References 28 publications

Solid Organ Transplantation From Hepatitis B Virus–Positive Donors: Consensus Guidelines for Recipient Management

Solid Organ Transplantation From Hepatitis B Virus–Positive Donors: Consensus Guidelines for Recipient Management

Risk factors of de novo hepatitis B virus infection in pediatric hepatitis B core antibody positive liver graft recipients under prophylactic therapy

Influence of graft size matching on outcomes of infantile living donor liver transplantation

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