Prevention and Management of HBV in Organ Transplantation

Celaj, Stela; Levitsky, Josh

doi:10.1007/s11901-020-00537-7

Cited by 1 publication

(6 citation statements)

References 81 publications

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“…Serological testing of anti-HBs should be carried out 1-2 months after the completion of the vaccine series to confirm immunity or the possible need to repeat vaccination and give a booster dose if the titer is decreased. 24,29 Antiviral therapy has increased the survival of HBsAg-positive kidney transplant recipients. Previously, recipients with positive HBsAg had a 2.49 times higher risk of death after kidney transplantation.…”

Section: Donormentioning

confidence: 99%

“…Despite the low transmission rates, guidelines recommended that HBcAb-positive non-immune graft recipients should continue to receive antiviral prophylaxis. 29,30 The optimal duration and timing of antiviral therapy for kidney transplant patients are difficult to assess because data regarding long-term outcomes after administration of nucleoside analogue therapy in immunosuppressed patients including kidney transplant recipients are lacking. However, expert opinions suggested that 6-12 months may be sufficient.…”

Section: Donormentioning

confidence: 99%

“…in patients receiving anti-rejection drug therapy. 29,30 12 months of therapy with antiviral agents without resistance. Periodic measurement of HBV DNA levels and liver enzyme testing for 3-6 months is very important when performing the antiviral treatment in case of growth immunosuppression, i.e.…”

Section: Donormentioning

confidence: 99%

“…in patients receiving anti-rejection drug therapy. 29,30 Although there are insufficient data to recommend prophylaxis in HBcAb-positive/HBsAg-negative recipients, trials of limited antiviral therapy may be considered especially during the first post-transplant year when immunosuppressive therapy is usually maximal. Alternatively, such patients should be monitored for reactivation (HBV serology/HBV DNA and liver function enzymes) every 3-6 months for at least the first post-transplant year.…”

Section: Donormentioning

confidence: 99%

“…Despite these findings, similar to liver transplantation, many transplant centers are reluctant to use HBsAg-positive grafts for kidney transplantation. 29,30…”

Section: Donormentioning

confidence: 99%

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Occult Hepatitis B Infection in Kidney Transplant Patients

Paramita

Wibawa

2022

InaJGHE

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Occult hepatitis B infection (OBI) is still a topic of debate worldwide. It is defined as the presence of hepatitis B virus (HBV) DNA in serum and/or liver from HBsAg-negative subjects. OBI may lead to the development of cirrhosis and hepatocellular carcinoma. It continues to present several unique challenges in organ transplantation despite the availability of an effective vaccine to prevent HBV infection and the introduction of oral therapy to treat HBV infection. HBV reactivation following organ transplantation can occur even in recipients with absent hepatitis B surface antigen and remains an important cause of morbidity and mortality. Concerning OBI complications, the screening of HBV DNA by the highly sensitive molecular means should be implemented for both recipients of organ transplant and organ transplant donors especially in highly endemic areas of HBV. In the era of potent antivirals and with evolving knowledge, HBsAg (+) renal transplant candidates and recipients can be monitored and successfully treated. Kidney organs from HBsAg-negative and anti-HBc–positive donors should be considered for transplant candidates after weighing the risk-benefit ratio. All transplant candidates should receive HBV vaccination if they are not immune to facilitate receipt of an organ from a donor with anti-HBc seropositivity.

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Section: Donormentioning

confidence: 99%

Section: Donormentioning

confidence: 99%

Section: Donormentioning

confidence: 99%

Section: Donormentioning

confidence: 99%

“…Despite these findings, similar to liver transplantation, many transplant centers are reluctant to use HBsAg-positive grafts for kidney transplantation. 29,30…”

Section: Donormentioning

confidence: 99%

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