The Safety of Transplanting a Hepatitis B Surface Antigen-Positive Kidney to a Recipient With Anti-Hepatitis B Surface Antibody: A Single-Center Experience

Chun-Chieh Tsai ； Yu Yang ； Ping-Fang Chiu

《Acta Nephrologica》 33卷4期 (2019/12) Pp. 182-188

https://doi.org/10.6221/AN.201912_33(4).0002

摘要

BACKGROUND: In Taiwan, a patient with end-stage renal disease (ESRD) and anti-hepatitis B surface antibody (anti-HBs Ab) could accept a kidney from a donor with a positive HBs antigen (HBs Ag). However, there are little data to support the safety of this type of transplantation procedure. METHODS: In our single-center retrospective study, 24 recipients received HBs Ag-positive kidneys. Of these patients, 12 recipients had anti-HBs Ab ＞ 10 mIU/mL, and the other 12 recipients had positive HBs Ag. RESULTS: The median follow-up time in these 2 groups was 2.64 and 12.46 years, respectively. In recipients with anti-HBs Ab, 2 received living kidney transplants. Seven patients received a booster vaccine of HBV before transplantation, and 9 recipients were administered entecavir prophylactically after the operation. There was no significant difference in most donor's and recipient's characteristics between these 2 groups. However, there were more diabetes mellitus recipients, female donors (n = 4), and donation after cardiac death (n = 6) in the group with anti-HBs Ab. After 12 months of transplantation, the recipients with anti-HBs Ab did not have more episodes of liver injury, and no case died from liver injury. There were also no significant differences in graft and patient survival between these 2 groups. CONCLUSION: Patients with ESRD and anti-HBs Ab may receive an HBs Ag-positive kidney under appropriate prophylaxis. They had no short-term major hepatic complications and comparable grafts and patient survival when comparing with HBs Ag-positive recipients.

關鍵字

donor-derived infections ； graft survival ； hepatitis B surface antigen ； hepatitis B virus ； kidney transplantation