Hepatitis B virus and renal transplantation

Kalia, Harmit; Fabrizi, Fabrizio; Martin, Paul

doi:10.1016/j.trre.2011.02.001

Cited by 18 publications

(25 citation statements)

References 81 publications

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“…Indeed, even if HBV transmission actually occurred, the most recent results of nucleoside analogs including lamivudine in treating HBV-infected KT were very good regarding antiviral potency and safety (25).…”

Section: The Outcomes Of Kt From Hbsag(þ) Donors To Hbsag(à) Recipientsmentioning

confidence: 99%

The Outcomes of Kidney Transplantation in Hepatitis B Surface Antigen (HBsAg)–Negative Recipients Receiving Graft From HBsAg-Positive Donors: A Retrospective, Propensity Score-Matched Study

Chancharoenthana

Townamchai

Pongpirul

et al. 2014

American Journal of Transplantation

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The outcomes of kidney transplantation (KT) from hepatitis B surface antigen-positive [HBsAg(þ)] donors to HBsAg(À) recipients remain inconclusive, possibly due to substantial differences in methodological and statistical models, number of patients, follow-up duration, hepatitis B virus (HBV) prophylactic regimens and hepatitis B surface antibody (anti-HBs) levels. The present retrospective, longitudinal study (clinicaltrial. gov NCT02044588) using propensity score matching technique was conducted to compare outcomes of KT between HBsAg(À) recipients with anti-HBs titer above 100 mIU/mL undergoing KT from HBsAg(þ) donors (n ¼ 43) and HBsAg(À) donors (n ¼ 86). During the median follow-up duration of 58.2 months (range 16.7-158.3 months), there were no significant differences in graft and patient survivals. No HBV-infective markers, including HBsAg, hepatitis B core antibody, hepatitis B extracellular antigen and HBV DNA quantitative test were detected in HBsAg(þ) donor group. Renal pathology outcomes revealed comparable incidences of kidney allograft rejection while there were no incidences of HBV-associated glomerulonephritis and viral antigen staining. Recipients undergoing KT from HBsAg(þ) donors with no HBV prophylaxis (n ¼ 20) provided comparable outcomes with those treated with lamivudine alone (n ¼ 21) or lamivudine in combination with HBV immunoglobulin (n ¼ 2). In conclusion, KT without HBV prophylaxis from HBsAg(þ) donors without hepatitis B viremia to HBsAg(À) recipients with anti-HBs titer above 100 mIU/mL provides excellent graft and patient survivals without evidence of HBV transmission.

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Section: The Outcomes Of Kt From Hbsag(þ) Donors To Hbsag(à) Recipientsmentioning

confidence: 99%

The Outcomes of Kidney Transplantation in Hepatitis B Surface Antigen (HBsAg)–Negative Recipients Receiving Graft From HBsAg-Positive Donors: A Retrospective, Propensity Score-Matched Study

Chancharoenthana

Townamchai

Pongpirul

et al. 2014

American Journal of Transplantation

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“…Unter Immunsuppression kann die Infektion mit Hepatitis-B-Virus rasch und schwer verlaufen und sich das Risiko für Escape-Mutanten des Virus, Zirrhose und hepatozelluläres Karzinom erhöhen, sodass ein guter Impfschutz vorhanden sein sollte [6]. Obwohl der rekombinante Impfstoff nach Transplantation nicht sehr gut immunogen ist, sollte eine fehlende Grundimmunisierung möglichst bald nachgeholt werden, am besten beginnend 6 Monate nach der Transplantation zu den Zeitpunkten 0, 1 und 6 Monaten.…”

Section: Totimpfstoffeunclassified

Impfen und prophylaktisches Infektionsmanagement

Huppertz¹

2012

Monatsschr Kinderheilkd

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“…Though HBsAg carrier rate, in China, has decreased from 9.8% in 1992 to 7.2% in 2006 following the universal application of hepatitis B vaccination 2 , it is estimated that 100 million people in China are still HBsAg-positive. HBV infection is more frequent in kidney transplant recipients than in the general population mainly due to the high risk of acquisition during dialysis, before kidney transplantation 3 . A survey conducted in 2003 suggests that the HBsAg carrier rate in 11 Asian-Pacific countries ranged from 2 to 10% in patients on peritoneal dialysis, 2 to 20% in patients on hemodialysis, and 1 to 25% in kidney transplant recipients 4 .…”

Section: Introductionmentioning

confidence: 99%

“…A survey conducted in 2003 suggests that the HBsAg carrier rate in 11 Asian-Pacific countries ranged from 2 to 10% in patients on peritoneal dialysis, 2 to 20% in patients on hemodialysis, and 1 to 25% in kidney transplant recipients 4 . The etiological factor, kidney transplantation, is further complicated by the use of immunosuppressants which may consequently enhance HBV replication 3 . Therefore, HBVinfection in kidney recipients is associated with a higher rate of liver-related morbidity and mortality 5 .…”

Section: Introductionmentioning

confidence: 99%

Post-transplant withdrawal of lamivudine results in fatal hepatitis flares in kidney transplant recipients, under immune suppression, with inactive hepatitis B infection

2017

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Objective: To evaluate the consequences of lamivudine withdrawal in kidney transplant recipients, under immunosuppression, with inactive hepatitis B virus (HBV) infection. Introduction: HBV infection is more frequent in kidney transplant recipients than in the general population mainly due to the high risk of acquisition during dialysis, before kidney transplantation. Methods: The records of hepatitis B surface antigen (HBsAg)-positive, immunosuppressed kidney transplant recipients, where lamivudine was withdrawn after transplantation along with reduction in immunosuppressant dose, admitted to our hospital between 2005 and 2012, were retrospectively evaluated. Discussion: Three patients aged 33, 42 and 33, experienced hepatitis flares 2-3 months after lamivudine withdrawal. Serum HBV DNA levels were 2.5×10 7 , 3.4×10 4 and 4×10 3 IU/ml in cases 1, 2, and 3, respectively. Lamivudine was re-initiated in all cases which led to rapid viral suppression. However, liver function continued to deteriorate leading to severe jaundice, coagulopathy and encephalopathy. All patients died of acute liver failure within six months after the onset of withdrawal hepatitis. Conclusion: Lamivudine should be continued as long as immunosuppressive therapy lasts.

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Hepatitis B virus and renal transplantation

Cited by 18 publications

References 81 publications

The Outcomes of Kidney Transplantation in Hepatitis B Surface Antigen (HBsAg)–Negative Recipients Receiving Graft From HBsAg-Positive Donors: A Retrospective, Propensity Score-Matched Study

The Outcomes of Kidney Transplantation in Hepatitis B Surface Antigen (HBsAg)–Negative Recipients Receiving Graft From HBsAg-Positive Donors: A Retrospective, Propensity Score-Matched Study

Impfen und prophylaktisches Infektionsmanagement

Post-transplant withdrawal of lamivudine results in fatal hepatitis flares in kidney transplant recipients, under immune suppression, with inactive hepatitis B infection

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