Transmission of hepatitis B by transplantation of livers from donors positive for antibody to hepatitis B core antigen. The National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database

Dickson, R. C.; Everhart, JE; Lake, John R.; Wei, Yue; Ec, Seaberg; Wiesner, R H; Rk, Zetterman; Pruett, T.; Ishitani, M.; Jh, Hoofnagle

doi:10.1053/gast.1997.v113.pm9352871

Cited by 392 publications

(359 citation statements)

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“…[4][5][6][7][8][9][10][11][12][13][14]19 In our study, 6 HBsAg-negative patients of 136 liver transplant recipients (4.4%) who survived more than 3 months developed posttransplantation hepatitis B. The potential sources of HBV infection after OLT include liver and blood donors and hospital personnel; also, after OLT, intravenous drug abuse or sexual transmission can 6 With PCR technology, a possible source of viral infection was identified in another 2 patients.…”

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7][8][9][10][11][12][13][14] Most of the reports of de novo HBV hepatitis showed a picture of mild chronic hepatitis, with only mild inflammatory activity on liver biopsy. Dickson et al 4 showed that 50% of infected patients had normal serum aminotransferase activities, and 85% had no or only mild inflammatory activity on liver biopsy. A relatively mild course was also noted in a series reported by Chazoulliéres et al, 6 Roche et al, 5 Douglas et al, 8 Liu et al, 13 Cavallari et al, 12 and Fabia et al 7 These data are in contrast to our experience.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Potential sources of HBV infection after OLT include liver and blood donors, hospital personnel, and the existence of a latent (occult) state of HBV infection in recipients. 4,6 The outcome of patients with de novo or occult HBV infection is generally better than that of patients with HBV reinfection; however, a wide spectrum of HBV liver diseases is possible, ranging from asymptomatic chronic carriers to severe chronic active hepatitis or cirrhosis. [4][5][6][7][8][9][10][11][12][13][14] To our knowledge, acute liver failure related to de novo HBV infection has not been described.…”

confidence: 99%

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Severe clinical course of de novo hepatitis B infection after liver transplantation

et al. 1999

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The aim of this study is to determine the origin, clinical outcome, allograft histological characteristics, and virological outcome of de novo hepatitis B virus (HBV) infection after orthotopic liver transplantation (OLT). We studied 136 hepatitis B surface antigen (HBsAg)-negative liver transplant recipients. HBV DNA was detected by dot-blot hybridization and polymerase chain reaction (PCR). The S gene was sequenced. Hepatitis C virus (HCV) RNA was assessed by PCR. The long-term clinical and histological outcome was determined. Six of 136 HBsAg-negative patients (4.4%) became HBsAg positive after transplantation. The source of HBV infection was reactivation of latent HBV infection in 2 patients and was not identified in 4 patients. Two donors had isolated core antibody. Two of these 6 patients developed acute liver failure related to hepatitis B. The 4 other patients had severe chronic hepatitis related to hepatitis B. All patients had high-level HBV replication. No significant mutations in the S gene were found. These data suggest that de novo hepatitis B infection is not a mild disease and might represent a significant cause of graft dysfunction. This is the first report of fulminant hepatitis caused by de novo hepatitis B infection after OLT.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Severe clinical course of de novo hepatitis B infection after liver transplantation

et al. 1999

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“…Patients undergoing liver transplantation have an increased risk of exposure to hepatitis B (HB) virus, mainly due to transmission of the virus from the donor organ and, to a lesser extent, due to multiple transfusions of blood products. [1][2][3][4] To protect these patients against de novo HB infection acquired during or after Abbreviations: HB, hepatitis B; HBsAg, hepatitis B surface antigen; anti-HBs, antibody to hepatitis B surface antigen; AS04, adjuvant system 04 containing aluminium and monophosphoryl lipid A; GMC, geometric mean concentration; SAE, serious adverse event. …”

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confidence: 99%

Immunogenicity and safety of an experimental adjuvanted hepatitis B candidate vaccine in liver transplant patients

et al. 2006

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Patients with chronic liver disease are at higher risk of hepatitis B (HB) virus infection before and after liver transplantation, and they commonly have a suboptimal immune response to HB vaccines. In this randomized trial, we compared the immunogenicity of primary vaccination with 2 doses of an experimental adjuvanted HB vaccine (adjuvant system 04 containing aluminium and monophosphoryl lipid A [HB-AS04] ) to that of 3 double doses of a licensed HB vaccine in 93 liver transplant candidates. Depending on the waiting list for liver transplantation, a booster dose of HB-AS04 or double booster dose of the licensed HB vaccine was given before or after surgery, at 6 to 12 months after initiation of the vaccination course. The percentage of subjects with seroprotective anti-HB surface antibody concentrations 1 month after booster was twice as high in the HB-AS04 group (60.0%), vs. patients in the comparator group (32.0%) (P ϭ 0.035). In subjects who did not undergo liver transplantation before administration of the booster, better immunogenicity results were obtained: 80% of subjects were seroprotected after HB-AS04 vaccination vs. 60% with the comparator (P ϭ 0.2302). Despite a slightly higher reactogenicity, the safety profile of the HB-AS04 vaccine was clinically acceptable. In conclusion, an improved antibody response was observed in liver transplant candidates with 3 doses of HB-AS04, as compared to 4 double doses of a comparator. Liver transplant candidates could benefit from the use of this experimental adjuvanted HB vaccine to further increase their protection against HB infection. Patients undergoing liver transplantation have an increased risk of exposure to hepatitis B (HB) virus, mainly due to transmission of the virus from the donor organ and, to a lesser extent, due to multiple transfusions of blood products. [1][2][3][4] To protect these patients against de novo HB infection acquired during or after Abbreviations: HB, hepatitis B; HBsAg, hepatitis B surface antigen; anti-HBs, antibody to hepatitis B surface antigen; AS04, adjuvant system 04 containing aluminium and monophosphoryl lipid A; GMC, geometric mean concentration; SAE, serious adverse event.

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Use of Hepatitis B Core Antibody-Positive Donors in Orthotopic Liver Transplantation

Holt¹

2002

Archives of Surgery

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Hypothesis: Hepatic allografts from donors positive for antibody to hepatitis B core antigen (anti-HBc) frequently transmit hepatitis B virus (HBV) infection to recipients. Therefore, most transplantation centers will not use these organs for orthotopic liver transplantation (OLT). Although it is expensive and not always efficacious, hepatitis B immune globulin (HBIG) has been used routinely for indefinite periods to prevent HBV infection in liver allograft recipients. We assessed the effectiveness of longterm use of a nucleoside analog, lamivudine, in preventing HBV transmission by anti-HBc-positive allografts.

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Transmission of hepatitis B by transplantation of livers from donors positive for antibody to hepatitis B core antigen. The National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database

Cited by 392 publications

References 3 publications

Severe clinical course of de novo hepatitis B infection after liver transplantation

Severe clinical course of de novo hepatitis B infection after liver transplantation

Immunogenicity and safety of an experimental adjuvanted hepatitis B candidate vaccine in liver transplant patients

Use of Hepatitis B Core Antibody-Positive Donors in Orthotopic Liver Transplantation

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