Premium
Prognostic implications of recipient or donor hepatitis B seropositivity in thoracic transplantation: analysis of 426 hepatitis B surface antigen‐positive recipients
Author(s) -
Manickam P.,
Krishnamoorthi R.,
Kanaan Z.,
Gunasekaran P.K.,
Cappell M.S.
Publication year - 2014
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12256
Subject(s) - medicine , hazard ratio , proportional hazards model , cohort , multivariate analysis , confidence interval , hepatitis b , gastroenterology , cohort study , survival analysis
Background Prognostic data on survival of hepatitis B surface antigen‐positive ( HB sAg+) recipients and of hepatitis B core antibody‐positive ( HB cAb+) donors are limited in the thoracic transplantation ( TT ) cohort. Improved understanding of risks could potentially expand the recipient and donor pools. Methods Post‐hoc analysis of limited‐access dataset of the United Network for Organ Sharing database from January 2000–September 2010 was performed. Analyses were performed for all TT , including single and bilateral lung, orthotopic heart, and simultaneous heart‐lung transplants. The primary analyzed outcome was overall survival. A Cox proportional multivariate hazards model was used to adjust for significant risk predictors. Results Of 24,817 patients included, 426 recipients were HB sAg+, of whom 106 (25%) died during a mean follow‐up of 3.6 years. On multivariate analysis, recipient HB sAg+ (hazard ratio [ HR ] = 0.88, 95% confidence interval [ CI ]: 0.69–1.32; P = 0.80), and donor HB cAb+ ( HR = 0.91, 95% CI : 0.68–1.22; P = 0.53) were not associated with increased overall mortality in the entire TT cohort, with similar results for each individual transplant cohort. Unadjusted survival analysis using Kaplan–Meier curves in individual transplant cohorts did not show significant differences between HB sAg+ and HB sAg− recipients. No statistically significant differences were found between causes of mortality in the 2 groups. Conclusion HB sAg+ status of recipients or HB cAb+ status of donors does not significantly affect overall survival of TT recipients. These data add to the scant literature on this subject and could potentially increase the donor and recipient pools.