Graduate School, Korea University College of Medicine, Seoul, South Korea.
Department of Trauma Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, the Catholic University of Korea, Uijeongbu, South Korea.
Ann Transplant. 2024 May 21;29:e943588. doi: 10.12659/AOT.943588.
BACKGROUND According to the current guidelines for liver transplantation (LT) of brain-dead donors with hepatitis B or C virus (HBV or HCV) in Korea, grafts from hepatitis B surface antigen (HBsAg)(+) or HCV antibody (anti-HCV)(+) donors must be transplanted only to HBsAg(+) or anti-HCV(+) recipients, respectively. We aimed to determine the current status and outcomes of brain-dead donor LT with HBV or HCV in Korea. MATERIAL AND METHODS This retrospective observational study included all LTs from brain-dead donors in the Korean Organ Transplantation Registry between April 2014 and December 2020. According to donor hepatitis status, 24 HBV(+), 1 HCV(+), and 1010 HBV(-)/HCV(-) donors were included. RESULTS Baseline/final model for end-stage liver disease score (MELD) for HBV(+), HCV(+), and HBV(-)/HCV(-) were 22.4±9.3/27.8±7.8, 16/11, and 33.0±15.4/35.5±7.1, respectively. MELD score of HBV (+) were lower than those of HBV(-)/HCV(-) (P<0.01). Five-year graft and patient survival rates of HBV(+) and HBV(-)/HCV(-) recipients were 81.7%/85.6%, and 76.6%/76.7%, respectively (P=0.73 and P=0.038). One-year graft and patient survival rates of HCV (+) graft recipients were both 100%. CONCLUSIONS No differences in graft and patient survival rates between HBV(+) and HBV(-)/HCV(-) groups were observed. Although accumulating the results of transplants from HBV (+) or HCV(+) grafts to HBV(-) or HCV(-) recipients is not possible owing to domestic regulations, Korea should conditionally permit transplantations from HBV(+) or HCV(+) grafts to HBV(-) or HCV(-) recipients by considering the risks and benefits based on foreign studies. Thereafter, we can accumulate the data from Korea and analyze the outcomes.
根据韩国目前针对乙型肝炎病毒（HBV）或丙型肝炎病毒（HCV）脑死亡供体肝移植的指南，来自 HBsAg（+）或抗 HCV（+）供体的移植物必须分别移植给 HBsAg（+）或抗 HCV（+）受体。我们旨在确定韩国 HBV 或 HCV 脑死亡供体肝移植的现状和结果。
本回顾性观察性研究纳入了 2014 年 4 月至 2020 年 12 月期间韩国器官移植登记处所有脑死亡供体的肝移植。根据供体肝炎状态，纳入 24 例 HBV（+）、1 例 HCV（+）和 1010 例 HBV（-）/HCV（-）供体。
HBV（+）、HCV（+）和 HBV（-）/HCV（-）的基线/终末期肝病模型（MELD）评分分别为 22.4±9.3/27.8±7.8、16/11 和 33.0±15.4/35.5±7.1。HBV（+）组的 MELD 评分低于 HBV（-）/HCV（-）组（P<0.01）。HBV（+）和 HBV（-）/HCV（-）受体的 5 年移植物和患者存活率分别为 81.7%/85.6%和 76.6%/76.7%（P=0.73 和 P=0.038）。HCV（+）移植物受体的 1 年移植物和患者存活率均为 100%。
HBV（+）和 HBV（-）/HCV（-）组之间的移植物和患者存活率无差异。尽管由于国内法规，不可能累积来自 HBV（+）或 HCV（+）供体的移植到 HBV（-）或 HCV（-）受体的结果，但韩国应根据外国研究，在考虑风险和收益的基础上，有条件地允许来自 HBV（+）或 HCV（+）供体的移植到 HBV（-）或 HCV（-）受体。此后，我们可以从韩国积累数据并分析结果。
