Use of hepatitis B surface antigen-positive grafts in liver transplantation: A matched analysis of the US National database.

TitleUse of hepatitis B surface antigen-positive grafts in liver transplantation: A matched analysis of the US National database.
Publication TypeJournal Article
Year of Publication2013
AuthorsLi Z, Hu Z, Xiang J, Zhou J, Yan S, Wu J, Zhou L, Zheng S
JournalLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Date Published2013 Oct 18
Abstract

The scarcity of available donor organs is the key challenge in orthotopic liver transplantation (OLT). A viable way of expanding the donor pool is the use of liver grafts from hepatitis B surface antigen (HBsAg)-positive donors. The present study used the US Scientific Registry of Transplant Recipients database (1987-2010), and each of the 78 patients who underwent OLT with HBsAg-positive grafts was matched with 4 patients who received HBsAg-negative grafts by urgent status, donor sex, recipient sex, donor age, recipient age, transplant date, Model for End-Stage Liver Disease score, and warm ischemia time. The overall graft and patient survival rates were similar for recipients of HBsAg-positive grafts and matched controls: the 5-year graft survival rates were 66% and 64%, respectively (P = 0.95), and the 5-year patient survival rates were 71% and 71%, respectively (P = 0.87). A Cox proportional hazards regression analysis that was adjusted for other variables showed no impact of the donor HBsAg status on graft or patient survival. The use of hepatitis B immunoglobulin (HBIG) was independently associated with better posttransplant graft survival [hazard ratio (HR) = 0.23, 95% confidence interval (CI) = 0.06-0.81] and patient survival (HR = 0.16, 95% CI = 0.04-0.75) for recipients of HBsAg-positive grafts. In conclusion, the use of HBsAg-positive liver grafts did not reduce posttransplant graft or patient survival. Moreover, matching these donors to recipients treated with HBIG may improve safety. Liver Transpl, 2013. © 2013 AASLD.

DOI10.1073/pnas.1314380110
Alternate JournalLiver Transpl.