Transplanting Hepatitis B Surface Antigen Positive Livers in the U.S.: Outcomes and Opportunities. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons Bhatnagar, A., Prakash, S., Lymberopoulos, P., Goff, C., Shaikh, A., Kim, D., Ahmed, A., Berg, C., Naggie, S., Kanwal, F., Cholankeril, G., Lee, T. H. 2023


Livers from donors with positive hepatitis B surface antigen (HBsAg+) have been used to expand the donor pool, but outcome data are limited. We aim to evaluate survival following liver transplant (LT) from HBsAg+ donors. Using the United Network for Organ Sharing registry, we identified HBsAg+ donors utilized for LT from 2009 to 2020. We used Kaplan-Meier survival and Cox proportional hazards regression to compare post-LT survival in HBV- recipients who utilized HBsAg+ donors to propensity-matched cohorts who utilized other types of donors. From 2009-2020, 70 patients received HBsAg+ livers, and 58 of them did not carry a diagnosis of chronic hepatitis B (HBV-). The 1 and 3-year post-LT survival for HBV- patients who received livers from HBsAg+ donors were 96.6% and 91.4%, respectively, with no statistical differences compared to patients received livers from HCV viremic donors (96.5%/93.0%, P=0.961/0.427), donation after cardiac death (DCD) donors (93.0%/86.0%, p=0.651/0.598), average risk donors (89.5%/86.0%, P=0.264/0.617), and combination of extended criteria donors, including DCD, donor age over 70, and graft with greater than 30% steatosis (93.0%/91.2%, P=0.621/0.785). Recipients of HBsAg+ livers have similar post-LT survival compared to those received other types of grafts. Increase utilization of HBsAg+ livers could safely expand the donor pool.

View details for DOI 10.1016/j.ajt.2023.04.024

View details for PubMedID 37116583