De novo hepatitis B virus infection after pediatric liver transplantations with hepatitis B core antibody-positive donors: a single-center 20-yr experience

Pediatr Transplant. 2015 May;19(3):267-72. doi: 10.1111/petr.12432. Epub 2015 Feb 4.

Abstract

DNHB is common in countries with high prevalence of hepatitis B, and therefore, contracting hepatitis B after LT with HBcAb(+) grafts is a major concern. We studied DNHB in 247 children (aged <18 yr) who underwent LT from 1994 to 2013. Sixty-six of 247 recipients received HBcAb(+) donor grafts. The incidence of DNHB was 5.7% (14 of 247 children) and that in HBcAb(+) donor grafts was 19.7% (13 of 66 children). The incidence of DNHB without LAM prophylaxis was 31.3% (nine of 29 children), while that with prophylaxis was 10.8% (four of 37 children). LAM prophylaxis negatively correlated with DNHB by Cox regression analysis (p = 0.028, odds ratio = 0.258). Among 13 DNHB patients with HBcAb(+) donor grafts, eight recovered from DNHB and four showed the emergence of LAM resistance. There was no DNHB-related graft failure. This study showed that HBcAb(+) donor graft was associated with development of DNHB, and use of LAM prophylaxis decreased the incidence of DNHB with HBcAb(+) graft.

Keywords: Korea; child; hepatitis B core antigen; liver transplantation.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Graft Survival
  • Hepatitis B / complications
  • Hepatitis B / etiology*
  • Hepatitis B Antibodies / blood*
  • Hepatitis B virus
  • Humans
  • Incidence
  • Lamivudine / therapeutic use
  • Liver Failure / complications
  • Liver Failure / surgery*
  • Liver Transplantation / adverse effects*
  • Living Donors
  • Male
  • Proportional Hazards Models
  • Republic of Korea
  • Retrospective Studies
  • Risk Factors

Substances

  • Hepatitis B Antibodies
  • Lamivudine