Heart transplantation using donors positive for hepatitis
Journal
Transplantation Proceedings
Journal Volume
36
Journal Issue
8
Pages
2371-2373
Date Issued
2004
Author(s)
Ko W.-J.
Tsao C.-I.
Lai M.-Y.
Liau C.-S.
Lee Y.-T.
Abstract
From May 1994 to September 2003, 177 hearts were procured for heart transplantation (HTx) from donors ranging in age from 1 year 2 months to 66 years 5 months (mean = 30 years). All donors and recipients received serologic tests for hepatitis B surface antigen (HBsAg) and antibody (anti-HBs), and hepatitis C virus antibody (anti-HCV). Thirty-two donors were HBsAg-positive and another four were anti-HCV-positive. Two HBsAg-positive donors were transplanted to patients with no previous evidence of hepatitis. After HTx, one received hepatitis B immunoglobulin prophylaxis and no hepatitis was noted during a 5 years follow-up. The other seroconverted at 4 months after HTx, requiring lamivudine treatment. Another four HBsAg-positive donors were transplanted to HBsAg-positive recipients. All four recipients had hepatitis flare-ups requiring lamivudine treatment. The other 26 HBsAg-positive donors were transplanted to anti-HBs-positive recipients. None suffered from hepatitis. Among the four patients receiving anti-HCV-positive hearts, seroconversion was noted in one recipient at 26 months. This patient never had clinical hepatitis before he died of allograft rejection at 3 years after HTx. The other three recipients remain anti-HCV negative during follow-up of 80, 50, and 46 months. It was concluded the hepatitis B- or C-positive donors could be used as heart donors for status 1 patients. Donors with positive HBsAg may be transplanted to anti-HBs-positive recipients with no HBV infection.
SDGs
Other Subjects
azathioprine; cyclosporin; hepatitis B antibody; hepatitis B surface antibody; hepatitis B surface antigen; hepatitis C antibody; lamivudine; meprednisone; mycophenolic acid 2 morpholinoethyl ester; prednisolone; recombinant hepatitis B vaccine; steroid; tacrolimus; thymocyte antibody; conference paper; controlled study; death; donor; female; follow up; graft rejection; heart transplantation; hepatitis B; hepatitis C; human; male; patient; postoperative period; priority journal; prophylaxis; seroconversion; side effect; Adolescent; Adult; Antiviral Agents; Brain Death; Cause of Death; Child; Child, Preschool; Female; Heart Transplantation; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis C; Humans; Infant; Lamivudine; Male; Middle Aged; Retrospective Studies; Tissue Donors
Type
conference paper