Organ Transplantation Service, The University of Tokyo Hospital, Tokyo, Japan.
Artificial Organ and Transplantation Division, Department of Surgery, The University of Tokyo, Tokyo, Japan.
Biosci Trends. 2019 Nov 13;13(5):448-455. doi: 10.5582/bst.2019.01283. Epub 2019 Oct 30.
The use of hepatitis B core antibody (anti-HBc)-positive grafts is one strategy for expanding the donor pool for liver transplantation (LT). The aim of this study was to determine the risk factors associated with hepatitis B virus (HBV) recurrence after living donor LT (LDLT) of anti-HBc-positive grafts. From January 1996 to December 2018, a total of 609 LDLT procedures were performed at our center. A retrospective review was performed for 31 patients (23 males and 8 females; median age = 47 years) who underwent LDLT for HBV-unrelated liver disease from anti-HBc-positive donors. The factors associated with HBV recurrence were evaluated and compared between the HBV recurrence and non-recurrence groups. The median follow-up period after LT was 135 months (range, 6-273 months). Four of 31 patients (12.9%) developed post-LT HBV recurrence. All four cases were HBV-naïve patients (anti-HBc-negative and Hepatitis B surface antibody-negative). The median interval between LDLT and HBV recurrence was 42 months (range, 20-51). The overall actuarial rates of HBV recurrence at 1, 3, 5, 10, and 20 years were 0%, 7.2%, 15.7%, 15.7%, and 15.7%, respectively. Although there were no significant differences between the HBV recurrence and non-recurrence groups, HBV recurrence tended to occur in HBV-naïve recipients (P = 0.093). HBV-naïve status may contribute to HBV recurrence after LDLT for HBV-unrelated liver disease from anti-HBc-positive donors. Careful monitoring for serological HBV markers is needed, particularly in this group.
使用乙型肝炎核心抗体（抗-HBc）阳性供体是扩大肝移植（LT）供体池的一种策略。本研究旨在确定与乙型肝炎病毒（HBV）在接受抗-HBc 阳性供体的活体供肝 LT（LDLT）后复发相关的危险因素。1996 年 1 月至 2018 年 12 月，本中心共进行了 609 例 LDLT 手术。对 31 例（23 名男性和 8 名女性；中位年龄=47 岁）因 HBV 无关肝病接受抗-HBc 阳性供体 LDLT 的患者进行了回顾性研究。评估了与 HBV 复发相关的因素，并比较了 HBV 复发组和非复发组之间的差异。LT 后中位随访时间为 135 个月（范围 6-273 个月）。31 例患者中有 4 例（12.9%）发生 LT 后 HBV 复发。这 4 例均为 HBV 初治患者（抗-HBc 阴性和乙型肝炎表面抗体阴性）。LDLT 与 HBV 复发之间的中位间隔为 42 个月（范围 20-51）。HBV 复发的总累计发生率在 1、3、5、10 和 20 年分别为 0%、7.2%、15.7%、15.7%和 15.7%。虽然 HBV 复发组和非复发组之间无显著差异，但 HBV 初治受者 HBV 复发倾向更高（P=0.093）。HBV 初治状态可能导致抗-HBc 阳性供体来源的 HBV 无关肝病 LDLT 后 HBV 复发。需要对血清学 HBV 标志物进行密切监测，尤其是在该组患者中。
