Outcomes of Liver Transplantation Using Hepatitis B Core-positive Liver Grafts: Implications for Prophylaxis

摘要

The number of patients listed for liver transplantation has outpaced the number of transplants that can be performed. This disparity between transplant candidates and the availability of donor grafts has led to an increase in mortality for patients waiting for liver transplantation. One strategy used to increase the donor pool has been the utilization of expanded donor grafts, such as those from donors with hepatitis B core antibody (anti-HBc). However, use of anti-HBc-positive grafts can potentially place the recipient at risk of de novo post-transplant hepatitis B virus (HBV) infection. The spectrum of liver disease from de novo hepatitis B ranges from mild hepatitis to graft loss. Fortunately, the risk of de novo HBV infection can be decreased with administration of oral nucleosides or nucleotides and hepatitis B immunoglobulin to the recipient. This review focuses on the epidemiology, natural history, and prophylactic strategies to reduce the risk of de novo hepatitis B in liver transplant recipients who receive anti-HBc-positive grafts.