Successful outcome of kidney transplantation from a HBV-DNA positive donor into recipients with cleared HBV-infection using a pre-emptive therapy approach

Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology
Janine MohrbachUrban Sester

Abstract

Donor-derived transmission of hepatitis B virus (HBV) may cause serious complications after transplantation. To date, transplantation from HBV-infected donors to HBV-infected recipients seems feasible, although this is recommended with prophylaxis with specific drugs and antibodies only, whereas pre-emptive strategies are rarely used. Here, we assessed the success of transplantation of kidneys from a chronically HBV-infected deceased donor (HBs-antigen positive, anti-HBc positive, HBV-DNA positive) to two recipients with cleared HBV-infection (HBs-antigen negative, anti-HBc positive, anti-HBs >100 IU/l) where risk-assessment was performed using a pre-emptive approach in the absence of prophylaxis. Pre-emptive monitoring included assessment for evidence of infection by analysis of liver enzymes, viral load, and humoral and cellular immunity against HBV and CMV. In line with undetectable HBV-load, HBc-specific T-cell frequencies remained stable (mean 0.46+/-0.10% and 0.06+/-0.03%), whereas CMV-specific T-cell frequencies in one patient showed dynamic changes that coincided with CMV-viremia. Likewise, HBV-specific antibody titres were stable. Liver enzymes demonstrated absence of liver-cell injury and renal function was good (crea...Continue Reading

References

Oct 26, 2000·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·G J WebsterA Bertoletti
Jul 9, 2002·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·R T ChungF L Delmonico
May 13, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Urban SesterMartina Sester
May 31, 2008·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·U SesterM Sester
Oct 4, 2008·The New England Journal of Medicine·Jules L Dienstag
Jun 23, 2009·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·H JiangJ Chen
Jan 28, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J LevitskyUNKNOWN AST Infectious Diseases Community of Practice
Jan 19, 2010·Proceedings of the National Academy of Sciences of the United States of America·Priscilla L YangFrancis V Chisari

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Citations

Mar 21, 2012·Transplantation·Helen L Pilmore, Edward J Gane
Dec 12, 2012·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Gurmukteshwar SinghGregory Braden
Oct 27, 2015·Journal of the Pediatric Infectious Diseases Society·Rebecca L RuebnerBenjamin L Laskin
Nov 15, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·W ChancharoenthanaS Eiam-Ong
Apr 22, 2015·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Heungman JunCheol Woong Jung

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