BACKGROUND: The shortage of available donors limits cardiac transplantation. Use of hearts from patients with hepatitis-B core antibodies could expand the donor pool but are usually avoided because of concern about virus transmission. We conducted a retrospective review to determine the safety of transplanting hearts from donors with hepatitis-B core antibodies. METHODS: We reviewed donor and recipient charts for patients who underwent transplantation at our center between January 1, 1997, and December 1, 2002. RESULTS: A total of 541 heart transplantations were performed in this time period. Thirty-three patients (aged 47.5 +/- 18.8 years) received hearts from core-antibody-positive donors (aged 37.7 +/- 10.8 years). Of these, 5 patients received prophylactic antibiotic treatment with lamivudine after transplantation. Only 1 patient (baseline surface-antigen-negative and without prophylaxis) experienced donor-transmitted hepatitis B infection 10 months after transplantation that was treated with lamivudine. Two patients (baseline surface-antibody-negative) had hepatitis B seroconversion, becoming surface-antibody positive without evidence of infection. None of the 5 patients who received prophylaxis with lamivudine had donor-transmitted hepatitis, and only 1 lamivudine-treated patient had surface antibodies. Post-transplant survival in this small cohort was similar to that for all patients who underwent transplantation at our center during this time period. CONCLUSIONS: Transplantation of hearts from donors with hepatitis-B core antibodies is associated with a small viral-transmission risk, with or without post-transplant, anti-viral prophylaxis. Use of these donor hearts should be considered safe and may help to augment the available donor pool.
BACKGROUND: The shortage of available donors limits cardiac transplantation. Use of hearts from patients with hepatitis-B core antibodies could expand the donor pool but are usually avoided because of concern about virus transmission. We conducted a retrospective review to determine the safety of transplanting hearts from donors with hepatitis-B core antibodies. METHODS: We reviewed donor and recipient charts for patients who underwent transplantation at our center between January 1, 1997, and December 1, 2002. RESULTS: A total of 541 heart transplantations were performed in this time period. Thirty-three patients (aged 47.5 +/- 18.8 years) received hearts from core-antibody-positive donors (aged 37.7 +/- 10.8 years). Of these, 5 patients received prophylactic antibiotic treatment with lamivudine after transplantation. Only 1 patient (baseline surface-antigen-negative and without prophylaxis) experienced donor-transmitted hepatitis B infection 10 months after transplantation that was treated with lamivudine. Two patients (baseline surface-antibody-negative) had hepatitis B seroconversion, becoming surface-antibody positive without evidence of infection. None of the 5 patients who received prophylaxis with lamivudine had donor-transmitted hepatitis, and only 1 lamivudine-treated patient had surface antibodies. Post-transplant survival in this small cohort was similar to that for all patients who underwent transplantation at our center during this time period. CONCLUSIONS: Transplantation of hearts from donors with hepatitis-B core antibodies is associated with a small viral-transmission risk, with or without post-transplant, anti-viral prophylaxis. Use of these donor hearts should be considered safe and may help to augment the available donor pool.
Authors: Glauco Adrieno Westphal; Valter Duro Garcia; Rafael Lisboa de Souza; Cristiano Augusto Franke; Kalinca Daberkow Vieira; Viviane Renata Zaclikevis Birckholz; Miriam Cristine Machado; Eliana Régia Barbosa de Almeida; Fernando Osni Machado; Luiz Antônio da Costa Sardinha; Raquel Wanzuita; Carlos Eduardo Soares Silvado; Gerson Costa; Vera Braatz; Milton Caldeira Filho; Rodrigo Furtado; Luana Alves Tannous; André Gustavo Neves de Albuquerque; Edson Abdala Journal: Rev Bras Ter Intensiva Date: 2016-09
Authors: Gang Xu; Chen-Hao Jiang; Yao Xiao; Tao Lyu; Li Jiang; Lyu-Nan Yan; Jia-Yin Yang Journal: Hepatobiliary Surg Nutr Date: 2022-04 Impact factor: 7.293
Authors: Edson Abdala; Luis Sérgio Fonseca de Azevedo; Vivian Iida Avelino-Silva; Sílvia Figueiredo Costa; Marlova Luzzi Caramori; Tania Mara Varejão Strabelli; Lígia Camera Pierrotti; Heloisa Helena de Souza Marques; Heloisa Helena Marques da Silva; Marta Heloisa Lopes; Glaucia Fernanda Varkulja; Vera Aparecida Santos; Maria Aparecida Shikanai-Yasuda Journal: Clinics (Sao Paulo) Date: 2012 Impact factor: 2.365