TY - JOUR
T1 - Outcomes among children who received a kidney transplant in the united states from a hepatitis b core antibody-positive donor, 1995-2010
AU - Ruebner, Rebecca L.
AU - Moatz, Taylor
AU - Amaral, Sandra
AU - Reese, Peter P.
AU - Blumberg, Emily A.
AU - Smith, Jodi M.
AU - Danziger-Isakov, Lara
AU - Laskin, Benjamin L.
N1 - Publisher Copyright:
© The Author 2015.
PY - 2016/12
Y1 - 2016/12
N2 - Background. Accepting kidneys for transplant from donors with a history of hepatitis B virus infection may increase the availability of organs for those with end-stage kidney disease. In adult recipients, kidney transplants from hepatitis B virus core antibody-positive donors have resulted in favorable graft and patient survival rates. However, pediatric organ transplant recipients have developing immune systems and a higher risk of infectious complications than adults. Accordingly, little is known about the outcomes of children who have received a kidney transplant from a hepatitis B virus core antibody-positive donor. Methods. We included 11 898 children ≤18 years of age who received a first kidney transplant in the United States between January 1, 1995, and December 31, 2010, and who were recorded in the Scientific Registry of Transplant Recipients.We examined differences in graft and patient survival rates among children who received a kidney transplant from a hepatitis B virus core antibody-positive donor. Results. There were 199 children (1.7%) who received a kidney transplant from a hepatitis B virus core antibody-positive donor.More than 80% of these transplants occurred in recipients who were hepatitis B virus core antibody and surface antigen negative. After a median follow-up of 7.9 years, there were no significant differences in the adjusted graft (hazard ratio [HR], 1.03 [95% confidence interval (CI), 0.80-1.31]) or patient (HR, 1.12 [95% CI, 0.73-1.73]) survival rates according to donor core antibody status. Conclusions. It may be acceptable, on a case-by-case basis, to consider hepatitis B virus core antibody-positive donors for kidney transplants to seroprotected children with end-stage kidney disease.
AB - Background. Accepting kidneys for transplant from donors with a history of hepatitis B virus infection may increase the availability of organs for those with end-stage kidney disease. In adult recipients, kidney transplants from hepatitis B virus core antibody-positive donors have resulted in favorable graft and patient survival rates. However, pediatric organ transplant recipients have developing immune systems and a higher risk of infectious complications than adults. Accordingly, little is known about the outcomes of children who have received a kidney transplant from a hepatitis B virus core antibody-positive donor. Methods. We included 11 898 children ≤18 years of age who received a first kidney transplant in the United States between January 1, 1995, and December 31, 2010, and who were recorded in the Scientific Registry of Transplant Recipients.We examined differences in graft and patient survival rates among children who received a kidney transplant from a hepatitis B virus core antibody-positive donor. Results. There were 199 children (1.7%) who received a kidney transplant from a hepatitis B virus core antibody-positive donor.More than 80% of these transplants occurred in recipients who were hepatitis B virus core antibody and surface antigen negative. After a median follow-up of 7.9 years, there were no significant differences in the adjusted graft (hazard ratio [HR], 1.03 [95% confidence interval (CI), 0.80-1.31]) or patient (HR, 1.12 [95% CI, 0.73-1.73]) survival rates according to donor core antibody status. Conclusions. It may be acceptable, on a case-by-case basis, to consider hepatitis B virus core antibody-positive donors for kidney transplants to seroprotected children with end-stage kidney disease.
KW - Children
KW - Hepatitis B
KW - Kidney transplant
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U2 - 10.1093/jpids/piv070
DO - 10.1093/jpids/piv070
M3 - Article
C2 - 26501473
AN - SCOPUS:85014792768
SN - 2048-7193
VL - 5
SP - 439
EP - 445
JO - Journal of the Pediatric Infectious Diseases Society
JF - Journal of the Pediatric Infectious Diseases Society
IS - 4
ER -