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A comprehensive study of the safety of using anti-hepatitis B core (Hbc) positive subjects in living donor liver transplants.

AbstractBACKGROUND/AIMS:
In recent years, only few reports have addressed the safety of using living donors with a positive anti-Hepatitis B Core (HBc) antibody for liver transplants. Most reports have focused on short-term complications, short-term changes in liver function and regeneration of remnant liver. Long term follow-up data, quality of life and overall laboratory tests variations have not been appropriately studied. In our study, we aim to comprehensively investigate the safety of using anti-HBc-positive subjects in living donor liver transplants (LDLT).
METHODOLOGY:
From March 2003 to March 2008, a total of 60 of LDLT cases were studied. All cases were right lobe transplants. Thirty donors with a positive anti-HBc were included in one group (group 1). The other 30 donors with a negative anti-HBc were included in Group 2. Preoperative parameters, intra-operative data, postoperative short- and long-term complications, laboratory tests and quality of life after surgery were compared.
RESULTS:
Preoperative demographic data, intra-operative data and graft size comparisons from both groups showed non-significant differences. Anti-HBc-positive donors (9 cases; 30%) showed more complications than negative donors (7 cases; 23.3%). However, the increase did not reach statistical significance (p = 0.563). The quality of life, postoperative serum Transaminase levels, prothrombin times and routine blood values showed non-significant differences. Anti-HBc positive donors showed higher levels of total bilirubin (TB), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) within the first 7 postoperative days. Nonetheless, all levels showed similar values for both groups in the days immediately following surgery. All indexes returned to normal levels, thirty days after surgery. However, a persistently decreased platelet count was observed in both groups.
CONCLUSIONS:
A positive serological test result for anti-HBc should not be considered as an absolute contraindication for LDLT. However, these cases require more caution than negative donors.
AuthorsJianyong Lei, Lunan Yan, Wentao Wang
JournalHepato-gastroenterology (Hepatogastroenterology) Vol. 60 Issue 126 Pg. 1426-32 (Sep 2013) ISSN: 0172-6390 [Print] Greece
PMID23933935 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Hepatitis B Antibodies
  • Hepatitis B Core Antigens
  • Aspartate Aminotransferases
  • Alanine Transaminase
Topics
  • Adult
  • Alanine Transaminase (blood)
  • Aspartate Aminotransferases (blood)
  • Female
  • Hepatitis B Antibodies (blood)
  • Hepatitis B Core Antigens (immunology)
  • Humans
  • Liver (physiopathology)
  • Liver Transplantation (adverse effects)
  • Living Donors
  • Male
  • Middle Aged
  • Platelet Count

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