De novo hepatitis B virus infection after pediatric liver transplantations with hepatitis B core antibody‐positive donors: A single‐center 20‐yr experience

DNHB is common in countries with high prevalence of hepatitis B, and therefore, contracting hepatitis B after LT with HB cAb + grafts is a major concern. We studied DNHB in 247 children (aged <18 yr) who underwent LT from 1994 to 2013. Sixty‐six of 247 recipients received HB cAb + donor grafts. The incidence of DNHB was 5.7% (14 of 247 children) and that in HB cAb + donor grafts was 19.7% (13 of 66 children). The incidence of DNHB without LAM prophylaxis was 31.3% (nine of 29 children), while that with prophylaxis was 10.8% (four of 37 children). LAM prophylaxis negatively correlated with DNHB by Cox regression analysis (p = 0.028, odds ratio = 0.258). Among 13 DNHB patients with HB cAb + donor grafts, eight recovered from DNHB and four showed the emergence of LAM resistance. There was no DNHB ‐related graft failure. This study showed that HB cAb + donor graft was associated with development of DNHB , and use of LAM prophylaxis decreased the incidence of DNHB with HB cAb + graft.