02687nas a2200277   4500008004100000020001400041024001700055245011700072210006900189260031200258300001200570490000700582520153400589653003202123653001602155653002202171653002602193653001902219100002102238700002102259700002202280700002702302700002002329700001502349856004502364       2006                        eng d  a0934-0874  aady, 890851600aUse of anti-HBc positive allografts in adult liver transplantation: toward a safer way to expand the donor pool.0 aUse of antiHBc positive allografts in adult liver transplantatio  aCopyright (C) 2006 Blackwell Publishing Ltd.b(1)Liver Transplant Unit, Cliniques Universitaires Saint-Luc, Universite catholique de Louvain, Brussels, Belgium(2)Department of Pathology, Cliniques Universitaires Saint-Luc, Universite catholique de Louvain, Brussels, Belgium(3)Unit Virology, Cliniquesc2006  a38 - 430 v193 aSummary: The use of livers from anti-hepatitis B core (HBc) positive donors can alleviate donor shortage. Nineteen of 367 (6%) adults receiving anti-HBc positive allografts [three were hepatitis B antigen (HBsAg) negative, hepatitis B antibody (HBsAb) positive; four were HBsAg positive and 12 were not exposed to hepatitis B viral (HBV) infection] were retrospectively reviewed. In HBsAg negative recipients, immunoprophylaxis (IP) was guided by viral serology and immunohistochemistry (IH) of day 0 and day 7 liver biopsies. If IH was negative, IP was stopped. None of three HBsAg negative, HBsAb positive recipients infected; one (replicating) of four HBsAg positive recipients reinfected and seven of eight (87.5%) HBsAg, HBsAb negative recipients, who did not receive long-term IP, infected after a median time of 2 years (range 1-5); one patient died of liver failure. Four HBsAg, HBsAb negative recipients, receiving life-long IP, remained infection free. Anti-HBc positive donor livers must be directed selectively first to HBsAg positive recipients, next to recipients having HBV antibodies and finally to HBV-naive recipients. Identification of both donor and recipient risk factors for HBV infection before transplantation allows indiscriminate use of antiviral prophylaxis. The necessity for IP therapy should be guided by HBV-DNA testing of donor liver tissue and serum. IH of early liver biopsies is an unreliable marker for predicting antiviral treatment requirements., Copyright (C) 2006 Blackwell Publishing Ltd.10aanti-hepatitis B core donor10aHepatitis B10aimmunoprophylaxis10aLiver Transplantation10amarginal donor1 aDonataccio, Dino1 aRoggen, Francine1 aDe Reyck, Chantal1 aVerbaandert, Catherine1 aBodeus, Monique1 aLerut, Jan  uhttps://notifylibrary.org/reference/4056