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Use of hepatitis B surface antigen-positive grafts in liver transplantation: A matched analysis of the US National database.
|Title||Use of hepatitis B surface antigen-positive grafts in liver transplantation: A matched analysis of the US National database.|
|Publication Type||Journal Article|
|Year of Publication||2013|
|Authors||Li Z, Hu Z, Xiang J, Zhou J, Yan S, Wu J, Zhou L, Zheng S|
|Journal||Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society|
|Date Published||2013 Oct 18|
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.
|Alternate Journal||Liver Transpl.|