Prevention of de novo hepatitis B infection in liver allograft recipients with previous hepatitis B infection or hepatitis B vaccination

Marugán, Rafael Bárcena; García-Hoz, F; Romero, Manuel Vázquez; Nash, R; Mateos, María Luisa; Alonso, Raquel Lahoz; González, Miguel; Plaza, A García

doi:10.1016/s0002-9270(02)04351-4

Cited by 11 publications

(6 citation statements)

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“…Numerous strategies are used to prevent HBV transmission, including passive immunization with HBIG and antiviral therapies. 2,4,9,[14][15][16][17] Previous studies have demonstrated that, in the absence of prophylactic therapy, HBV-naïve recipients (HBsAb-HBcAb-) had an approximately 76% chance of developing HBV infection and no instances of HBsAb+ HBcAb+ patients developing HBV after transplantation have been reported. 2,5 Consequently, many transplant centres have restricted the use of HBcAb+ grafts to HBV+ recipients.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 These include matching with specific recipients who are also HBcAb-positive (HBcAb+), as well as the administration of prophylaxis against hepatitis B infection to recipients. [2][3][4] Rates of hepatitis B transfection from infected grafts performed prior to the routine use of prophylaxis therapy were 50-75%. 5,6 A number of approaches were attempted to reduce these rates of infection, including transplantation into recipients with evidence of past HBV infection (15% infection rate), and pre-transplant immunization (10% infection rate).…”

Section: Introductionmentioning

confidence: 99%

“…5,6 A number of approaches were attempted to reduce these rates of infection, including transplantation into recipients with evidence of past HBV infection (15% infection rate), and pre-transplant immunization (10% infection rate). [2][3][4]7 The administration of immunoglobulin against HBV, as well as antiviral therapy, has promoted the use of HBcAb+ grafts in non-HBV recipients. 8 Since the introduction of immunoglobulin and antiviral treatment strategies, the reported incidence of HBV arising from graft transfection has reduced dramatically.…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of HBcAb among potential donors is as high as 15% in some urban US centres and a number of strategies to utilize these organs have been developed 1,2 . These include matching with specific recipients who are also HBcAb‐positive (HBcAb+), as well as the administration of prophylaxis against hepatitis B infection to recipients 2–4 …”

Section: Introductionmentioning

confidence: 99%

“…Rates of hepatitis B transfection from infected grafts performed prior to the routine use of prophylaxis therapy were 50–75% 5,6 . A number of approaches were attempted to reduce these rates of infection, including transplantation into recipients with evidence of past HBV infection (15% infection rate), and pre‐transplant immunization (10% infection rate) 2–4,7 . The administration of immunoglobulin against HBV, as well as antiviral therapy, has promoted the use of HBcAb+ grafts in non‐HBV recipients 8 .…”

Section: Introductionmentioning

confidence: 99%

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Utilization of hepatitis B core antibody-positive donor liver grafts

MacConmara

Vachharajani

Wellen

et al. 2012

HPB

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Utilization of hepatitis B core antibody-positive donor liver grafts

MacConmara

Vachharajani

Wellen

et al. 2012

HPB

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De novo hepatitis b prophylaxis with hepatitis B virus vaccine and hepatitis B immunoglobulin in pediatric recipients of core antibody–positive livers

et al. 2016

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The use of hepatitis B core antibody-positive (HBcAb1) grafts for liver transplantation (LT) has the potential to safely expand the donor pool, as long as proper prophylaxis against de novo hepatitis B (DNHB) is employed. The aim of this study was to characterize the longterm outcome of pediatric LT recipients of HBcAb1 liver grafts under a prophylaxis regimen against DNHB using hepatitis B virus (HBV) vaccine and hepatitis B immunoglobulin (HBIG). From June 1996 to February 2013, 49 patients receiving pediatric LT at our center were from HBcAb1 donors. Forty-one patients who received DNHB prophylaxis according to our protocol were included in this analysis. Our DNHB prophylaxis protocol consists of HBV vaccine intramuscular injections given intermittently to maintain anti-hepatitis B surface antibody (HBsAb) titers above 100 IU/L. HBIG was also used during the first posttransplant year with a target anti-HBsAb titer level above 200 IU/L. There were 19 boys and 22 girls. Median age was 1.0 year (range, 4 months to 16 years). Median follow-up time was 66 months after transplant. Median annual number of HBV vaccine injections was 0.8 per year (range, 0-1.8 per year). Four patients did not require any HBV vaccine injections during follow-up. One patient with DNHB was encountered during the follow-up period (1/41, 2.4%). DNHB was diagnosed at 3.5 years after transplant, when hepatitis B surface antigen was positive upon routine follow-up serologic testing. Anti-HBsAb titer was 101.5 IU/L at the time. No grafts were lost because of DNHB-related events. Overall survival of the 41 recipients of HBcAb1 grafts who received DNHB prophylaxis was 92.3% at 10 years after transplant. In conclusion, longterm prophylaxis against DNHB with HBV vaccine in pediatric LT recipients of HBcAb1 grafts was safe and effective in terms of DNHB incidence as well as graft and patient survival. The use of hepatitis B core antibody-positive (HBcAb1) grafts for liver transplantation (LT) has the potential to expand the donor pool, especially in hepatitis B virus (HBV) endemic areas.1 Studies have found the use of HBcAb1 livers to be safe as long as proper prophylaxis against de novo hepatitis B (DNHB) is employed.2,3 Several different approaches for DNHB prophylaxis have been used in recipients of HBcAb1 livers according to preference and experience of each institution, including nucleos(t)ide analogues (NUCs) and hepatitis B immunoglobulin (HBIG) or a combination of both. 4 A recently published consensus guideline recommended the use of lamivudine for DNHB prophylaxis in this clinical setting.5 However, this consensus guideline could not set forth an optimal recommendation for the pediatric population, whereas adding that HBV Abbreviations: DNHB, de novo hepatitis B; HBcAb1, hepatitis B core antibody-positive; HBIG, hepatitis B immunoglobulin; HBsAb, hepatitis B surface antibody; HBsAg, hepatitis B surface antigen; HBV, hepatitis B virus; LT, liver transplantation; NUC, nucleos(t)ide analogue; PELD, Pediatric End-Stage Liver Disease.Grants or...

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Organ Transplantation in HBV-Infected Patients

Chen

2016

Molecular and Translational Medicine

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Prevention of de novo hepatitis B infection in liver allograft recipients with previous hepatitis B infection or hepatitis B vaccination

Cited by 11 publications

References 0 publications

Utilization of hepatitis B core antibody-positive donor liver grafts

Utilization of hepatitis B core antibody-positive donor liver grafts

De novo hepatitis b prophylaxis with hepatitis B virus vaccine and hepatitis B immunoglobulin in pediatric recipients of core antibody–positive livers

Organ Transplantation in HBV-Infected Patients

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