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Outcomes of hepatitis C- and hepatitis B core antibody-positive grafts in orthotopic liver transplantation.
Liver Transpl 2003; 9(10):1053-61LT

Abstract

The use of hepatitis B core antibody (HBcAb)- and hepatitis C virus antibody (HCV+) liver grafts for transplantation in selected populations has not affected patient and graft survival. We reexamined the clinical outcomes of using these HBcAb+ and HCV+ grafts at our institution, in addition to studying recipients of combined HBcAb+/HCV+ grafts. We identified 377 patients who underwent transplantation for either hepatitis B and/or hepatitis C, or received both HBcAb+ and HCV+ grafts. Patient and graft survival at 5 years posttransplantation was 73% and 71%, respectively, in the HBcAb+ grafts compared with 81% and 75% in the HBcAb- grafts (P =.65; P =.94). For HCV+ grafts, patient and graft survival at 5 years posttransplantation was 89% and 73%, respectively, compared with 69% and 59% in the HCV- grafts; (P =.22; P =.77). The 5-year patient and graft survival rate in those who received combined HBcAb+/HCV+ grafts was 74% and 69%, respectively, and there was no statistical difference compared with the HBcAb+ and HCV+ grafts (P =.76; P =.90). The 5-year patient and graft survival rate in patients who received dual HBV prophylaxis with hepatitis B immunoglobulin (HBIg) and lamivudine was 88% and 84%, respectively, which was significantly higher than for patients who received single prophylaxis or no prophylaxis (P <.01; P =.02). Our study supports previous observations that patient and graft survival is not affected with the use of HBcAb+ and HCV+ grafts, and that dual prophylaxis with HBIg and lamivudine offers substantial survival benefits. Furthermore, the use of combined HBcAb+/HCV+ grafts did not impact patient or graft survival. This provides a potential new pool of donor livers that can be used for transplantation in select patients.

Authors+Show Affiliations

Department of Medicine, Division of Digestive Diseases, Dumont-UCLA Liver Transplant Center, University of California Los Angeles, 90095, USA. Ssaab@mednet.ucla.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14526400

Citation

Saab, Sammy, et al. "Outcomes of Hepatitis C- and Hepatitis B Core Antibody-positive Grafts in Orthotopic Liver Transplantation." Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, vol. 9, no. 10, 2003, pp. 1053-61.
Saab S, Chang AJ, Comulada S, et al. Outcomes of hepatitis C- and hepatitis B core antibody-positive grafts in orthotopic liver transplantation. Liver Transpl. 2003;9(10):1053-61.
Saab, S., Chang, A. J., Comulada, S., Geevarghese, S. K., Anselmo, R. D., Durazo, F., ... Busuttil, R. W. (2003). Outcomes of hepatitis C- and hepatitis B core antibody-positive grafts in orthotopic liver transplantation. Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 9(10), pp. 1053-61.
Saab S, et al. Outcomes of Hepatitis C- and Hepatitis B Core Antibody-positive Grafts in Orthotopic Liver Transplantation. Liver Transpl. 2003;9(10):1053-61. PubMed PMID: 14526400.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of hepatitis C- and hepatitis B core antibody-positive grafts in orthotopic liver transplantation. AU - Saab,Sammy, AU - Chang,Albert J, AU - Comulada,Scott, AU - Geevarghese,Sunil K, AU - Anselmo,R Dean M, AU - Durazo,Francisco, AU - Han,Steven, AU - Farmer,Douglas G, AU - Yersiz,Hasan, AU - Goldstein,Leonard I, AU - Ghobrial,R Mark, AU - Busuttil,Ronald W, PY - 2003/10/4/pubmed PY - 2004/2/24/medline PY - 2003/10/4/entrez SP - 1053 EP - 61 JF - Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society JO - Liver Transpl. VL - 9 IS - 10 N2 - The use of hepatitis B core antibody (HBcAb)- and hepatitis C virus antibody (HCV+) liver grafts for transplantation in selected populations has not affected patient and graft survival. We reexamined the clinical outcomes of using these HBcAb+ and HCV+ grafts at our institution, in addition to studying recipients of combined HBcAb+/HCV+ grafts. We identified 377 patients who underwent transplantation for either hepatitis B and/or hepatitis C, or received both HBcAb+ and HCV+ grafts. Patient and graft survival at 5 years posttransplantation was 73% and 71%, respectively, in the HBcAb+ grafts compared with 81% and 75% in the HBcAb- grafts (P =.65; P =.94). For HCV+ grafts, patient and graft survival at 5 years posttransplantation was 89% and 73%, respectively, compared with 69% and 59% in the HCV- grafts; (P =.22; P =.77). The 5-year patient and graft survival rate in those who received combined HBcAb+/HCV+ grafts was 74% and 69%, respectively, and there was no statistical difference compared with the HBcAb+ and HCV+ grafts (P =.76; P =.90). The 5-year patient and graft survival rate in patients who received dual HBV prophylaxis with hepatitis B immunoglobulin (HBIg) and lamivudine was 88% and 84%, respectively, which was significantly higher than for patients who received single prophylaxis or no prophylaxis (P <.01; P =.02). Our study supports previous observations that patient and graft survival is not affected with the use of HBcAb+ and HCV+ grafts, and that dual prophylaxis with HBIg and lamivudine offers substantial survival benefits. Furthermore, the use of combined HBcAb+/HCV+ grafts did not impact patient or graft survival. This provides a potential new pool of donor livers that can be used for transplantation in select patients. SN - 1527-6465 UR - https://www.unboundmedicine.com/medline/citation/14526400/Outcomes_of_hepatitis_C__and_hepatitis_B_core_antibody_positive_grafts_in_orthotopic_liver_transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1527646503504166 DB - PRIME DP - Unbound Medicine ER -