Anti-HBs re-seroconversion after liver transplantation in a patient with past HBV infection receiving a HBsAg positive graft

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J Hepatol. 2009 Mar;50(3):625-30. Epub 2008 Dec 25.

Anti-HBs re-seroconversion after liver transplantation in a patient with past

HBV infection receiving a HBsAg positive graft.

Loggi E, Bihl F, Chisholm JV 3rd, Biselli M, Bontadini A, Vitale G, Ercolani G,

Grazi GL, Pinna AD, Bernardi M, Brander C, Andreone P.

Department of Clinical Medicine, University of Bologna, Bologna, Italy.

BACKGROUND/AIMS: Orthotopic liver transplantation (OLT) is an important

therapeutic option for HBV-related end-stage-liver disease, yet it is often

hampered by a scarcity of organ availability. One option to increase organ

availability is the use of virologically compromised organs from HBV-infected

donors. Transplantation of anti-HBcore positive grafts has been associated with

a low risk of HBV recurrence if adequately treated with nucleoside analogs,

irrespective of concomitant HBV-specific immunoglobulin therapy. Experience

using HBsAg positive grafts is, however, very limited. METHODS: Here, the

analysis of the cellular and humoral HBV-specific immunity of a subject with

past HBV infection (anti-HBs and anti-HBc positive) receiving an HBsAg positive

liver graft is reported. RESULTS: Nine months post-OLT, the patient experienced

a spontaneous anti-HBs re-seroconversion allowing the discontinuation of HBIG.

The data show a concurrent increase in the cellular and humoral immunity at

times of reduced viral antigenemia, demonstrating effective immune control of

HBV post-OLT. CONCLUSIONS: These data support the use of marginal organs in this

setting, providing a potential strategy to further alleviate organ shortage.

PMID: 19157623 [PubMed - indexed for MEDLINE]