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Kidney Transplantation from Hepatitis B Surface Antigen Positive Donors into Hepatitis B Surface Antibody Positive Recipients: A Prospective Nonrandomized Controlled Study from a Single Center
Author(s) -
Jiang H.,
Wu J.,
Zhang X.,
Wu D.,
Huang H.,
He Q.,
Wang R.,
Wang Y.,
Zhang J.,
Chen J.
Publication year - 2009
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2009.02707.x
Subject(s) - medicine , hbsag , hepatitis b virus , hepatitis b , transplantation , kidney transplantation , liver transplantation , gastroenterology , immunology , lamivudine , virus
The number of patients on renal transplant waiting list is increasing rapidly in many countries, exacerbating the shortage of organs. We conducted a study to evaluate the safety and efficacy of deceased‐donor kidney transplantation from hepatitis B surface antigen (HBsAg)‐positive (+) donors into hepatitis B surface antibody (anti‐HBs)‐positive (+) recipients. Sixty‐five patients received grafts from HBsAg(+) donors, and 308 subjects received grafts from HBsAg‐negative(−) donors. Posttransplantation, recipients with HBsAg(−) grafts or HBsAg(+) grafts received 400 U of hepatitis B immunoglobulin once and twice, respectively. The seven recipients who received grafts from hepatitis B virus (HBV) DNA(+) donors were treated with hepatitis B immunoglobulin 400 U weekly for 3 months and lamivudine 100 mg daily for 6 months. All patients were monitored for liver function and hepatitis B viral status. The follow‐up period was 38.7 ± 15.4 months. Although two recipients developed de novo HBV infection, neither patient developed severe liver dysfunction nor died. The incidence of liver injury (39/65 vs. 207/308, chi‐square test, p > 0.05) and survival (log‐rank test, p > 0.05) did not differ between the groups. We conclude that anti‐HBs(+) recipients receiving HBsAg(+) grafts did as well as those receiving HBsAg(−) grafts.