Living-Donor Kidney Transplant From Hepatitis B Surface Antigen-Positive Donors to Hepatitis B Antibody-Positive Recipients Without Hepatitis B Immunoglobulin Prophylaxis in an Endemic Country

Jun, Heungman; Kim, Myung Gyu; Park, Kwan Tae; Jung, Cheol Woong

doi:10.6002/ect.mesot2014.p60

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…Therefore, entecavir has replaced lamivudine as first‐line therapy for treatment‐naïve recipients following HBV infection 24 . In addition, the utilization of HBV IgG has fallen out of favor in transplant literature as a preventive therapy following HBV+ kidney transplant 25–27 . Also, HBV immunization has been shown to be effective in preventing post‐transplant complications following HBV+ transplants 18,28 .…”

Section: Discussionmentioning

confidence: 99%

“…24 In addition, the utilization of HBV IgG has fallen out of favor in transplant literature as a preventive therapy following HBV+ kidney transplant. [25][26][27] Also, HBV immunization has been shown to be effective in preventing posttransplant complications following HBV+ transplants. 18,28 However, the length of course of therapy is not clear though the American Society of Transplantation recommended continuing antiviral prophylaxis for up to 1 year in susceptible non-liver recipients of HBcAb+/HBsAgdonors.…”

Section: Hbv Nat+ Donors N=16mentioning

confidence: 99%

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Utilization of Hepatitis B viremic donors (NAT+) leads to improved kidney transplant access for older adult recipients with little to no wait time

Lopez‐Soler,

Joyce,

Cotiguala

et al. 2024

Transplant Infectious Dis

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BackgroundThough the use of Hepatitis B viremic (HBV) donor kidneys may be a safe alternative to improve access to transplantation, there has not been wide acceptance of this practice. In this study, we determined the safety and effectiveness of HBV NAT (+) donor kidneys in a protocolized manner in an older adult population.MethodsOver a 3‐year period, 16 decreased donor kidney transplants were performed with HBV NAT+ kidneys. Recipients of HBV NAT+ kidneys were treated with entecavir started pre‐operatively and continued for 52 weeks.ResultsHBV NAT+ kidneys were preferentially used in older (68 ± 5 vs. 64 ± 9 years; p = .01) recipients with less dialysis time (93.8% < 5 years vs. 67% <5 years; p = .03). In this cohort, 3/16 had detectable HBV PCR 1‐week post‐transplant, but all were negative at 9‐ and 12‐months. Calculated estimated glomerular filtration rate (eGFR) was slightly decreased 12‐months post‐transplant. Post‐transplant outcomes in an age‐matched cohort showed no difference in rates of delayed graft function, readmission within 30 days, and graft loss or death within 6 months of transplant (p > .05).ConclusionTransplants with HBV NAT+ donor kidneys in a pre‐emptive treatment protocol allow for increased safe access to transplantation in older adult recipients with little or no dialysis time. image

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Section: Discussionmentioning

confidence: 99%

Section: Hbv Nat+ Donors N=16mentioning

confidence: 99%

Utilization of Hepatitis B viremic donors (NAT+) leads to improved kidney transplant access for older adult recipients with little to no wait time

Lopez‐Soler,

Joyce,

Cotiguala

et al. 2024

Transplant Infectious Dis

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High-Risk Living Kidney Donors

Kant

Segev

Alachkar

2022

Living Kidney Donation

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Risk of disease transmission in an expanded donor population: the potential of hepatitis B virus donors

Zhou

2020

Current Opinion in Organ Transplantation

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Purpose of review Lack of availability of donor organs is a constant challenge that patients and providers face in transplantation. To address this shortage, donors that test positive for hepatitis B, in particular those with resolved infection, have been increasingly utilized in clinical practice. We review here the potential risks for the recipient and the advances in hepatitis B management that have made use of these donors a well tolerated and advisable proposition. Recent findings As routine administration of antiviral prophylaxis in the posttransplant setting among those deemed high risk for transmission, outcomes for recipients of hepatitis B donors, including liver transplant recipients, have been comparable to uninfected donors. Universal hepatitis B nucleic acid testing of donors has also enhanced our ability to accurately inform recipients regarding transmission risk. Appropriate use of prophylaxis and careful monitoring for transmission posttransplant is key to ensuring no adverse outcomes occur. Summary Treatment of hepatitis B has evolved over the past two decades. Expanding the donor pool with hepatitis B donors is now well tolerated, ethical, and advantageous to the transplant community at large. A clear discussion with recipients on the substantial benefit and low harm of using hepatitis B donors will lead to greater acceptance and utilization of these organs.

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Living-Donor Kidney Transplant From Hepatitis B Surface Antigen-Positive Donors to Hepatitis B Antibody-Positive Recipients Without Hepatitis B Immunoglobulin Prophylaxis in an Endemic Country

Cited by 4 publications

References 14 publications

Utilization of Hepatitis B viremic donors (NAT+) leads to improved kidney transplant access for older adult recipients with little to no wait time

Utilization of Hepatitis B viremic donors (NAT+) leads to improved kidney transplant access for older adult recipients with little to no wait time

High-Risk Living Kidney Donors

Risk of disease transmission in an expanded donor population: the potential of hepatitis B virus donors

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