I. Jankowska, J. Pawłowska, P. Kaliciński, M. Teisseyre, A. Kamiński, J. Kuszyk, P. Kluge, M. Pronicki, J. Socha
Med Sci Monit 2003; 9(2): 20-
Background: Transmissions of hepatitis B virus (HBV)infection from donors negative for hepatitis B surface antigen (HBsAg)but positive for antibody to hepatitis B core antigen (anti-HBc) have been reported.The recipient risk to develop hepatitis B from an anti-HBc positive donors has been estimated to be up to 78%but in emergency cases the decision to perform trans- plantation should be considered. The aim of the study was to analyse the outcome of living related anti-HBc positive donor liver transplantation in children. Material/Methods:3 out of 88 children with living related liver transplantation received a liver from an anti-HBc positive donor.All children had liver cirrhosis due to biliary atresia. Transplantation was done at the age of 12.21 and 22 months, in life-threatening situations,after 6 month waiting time for cadaveric liver transplantation.Recipients were HBsAg and anti-HBc negative.All children were vaccinated before transplantation with anti-HBs title above 1000 mIU/ml on the day of transplantation.In all living related donors HBsAg and anti-HBc antibody were determined before transplantation. Three anti-HBc positive donors were tested for HBV DNA in serum and liver by PCR method. Results:Serum of all anti-HBc positive donors was negative for HBV DNA. Liver biopsies showed no inflammation but in two cases liver tissue was positive for HBV-DNA by PCR test.All three recipients are followed up for 10 –24 months after liver transplantation.None of them developed HBV infection. Conclusions: 1.In case of life threatening situations anti-HBc positive donors can be accepted for living related liver transplantation.2.It is important to vaccinate and verify the antibody response to the vaccination before and after transplantation.
Keywords: Hepatitis B