Solid organ transplantation from hepatitis B virus-positive donors: Consensus guidelines for recipient management

S. Huprikar, L. Danziger-Isakov, J. Ahn, S. Naugler, E. Blumberg, R. K. Avery, C. Koval, E. D. Lease, A. Pillai, K. E. Doucette, J. Levitsky, M. I. Morris, K. Lu, J. K. McDermott, T. Mone, J. P. Orlowski, D. M. Dadhania, K. Abbott, S. Horslen, B. L. LaskinA. Mougdil, V. L. Venkat, K. Korenblat, V. Kumar, P. Grossi, R. D. Bloom, K. Brown, C. N. Kotton, D. Kumar

Research output: Contribution to journalArticle

Abstract

Use of organs from donors testing positive for hepatitis B virus (HBV) may safely expand the donor pool. The American Society of Transplantation convened a multidisciplinary expert panel that reviewed the existing literature and developed consensus recommendations for recipient management following the use of organs from HBV positive donors. Transmission risk is highest with liver donors and significantly lower with non-liver (kidney and thoracic) donors. Antiviral prophylaxis significantly reduces the rate of transmission to liver recipients from isolated HBV core antibody positive (anti-HBc+) donors. Organs from anti-HBc+ donors should be considered for all adult transplant candidates after an individualized assessment of the risks and benefits and appropriate patient consent. Indefinite antiviral prophylaxis is recommended in liver recipients with no immunity or vaccine immunity but not in liver recipients with natural immunity. Antiviral prophylaxis may be considered for up to 1 year in susceptible non-liver recipients but is not recommended in immune non-liver recipients. Although no longer the treatment of choice in patients with chronic HBV, lamivudine remains the most cost-effective choice for prophylaxis in this setting. Hepatitis B immunoglobulin is not recommended.

Original languageEnglish (US)
Pages (from-to)1162-1172
Number of pages11
JournalAmerican Journal of Transplantation
Volume15
Issue number5
DOIs
StatePublished - May 1 2015

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Keywords

  • clinical research/practice
  • donors and donation: donor-derived infections
  • infection and infectious agents
  • infectious disease
  • viral: hepatitis B

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

Huprikar, S., Danziger-Isakov, L., Ahn, J., Naugler, S., Blumberg, E., Avery, R. K., Koval, C., Lease, E. D., Pillai, A., Doucette, K. E., Levitsky, J., Morris, M. I., Lu, K., McDermott, J. K., Mone, T., Orlowski, J. P., Dadhania, D. M., Abbott, K., Horslen, S., ... Kumar, D. (2015). Solid organ transplantation from hepatitis B virus-positive donors: Consensus guidelines for recipient management. American Journal of Transplantation, 15(5), 1162-1172. https://doi.org/10.1111/ajt.13187