Abstract

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