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J Heart Lung Transplant. 2005 Jan;24(1):34-7.

Acceptable recipient outcomes with the use of hearts from donors with hepatitis-B core antibodies.

Author information

  • 1Division of Circulatory Physiology, New York Presbyterian Hospital, MHB5-435, 177 Fort Washington Avenue, New York, New York 10032, USA. sp461@columbia.edu

Abstract

BACKGROUND:

The shortage of available donors limits cardiac transplantation. Use of hearts from patients with hepatitis-B core antibodies could expand the donor pool but are usually avoided because of concern about virus transmission. We conducted a retrospective review to determine the safety of transplanting hearts from donors with hepatitis-B core antibodies.

METHODS:

We reviewed donor and recipient charts for patients who underwent transplantation at our center between January 1, 1997, and December 1, 2002.

RESULTS:

A total of 541 heart transplantations were performed in this time period. Thirty-three patients (aged 47.5 +/- 18.8 years) received hearts from core-antibody-positive donors (aged 37.7 +/- 10.8 years). Of these, 5 patients received prophylactic antibiotic treatment with lamivudine after transplantation. Only 1 patient (baseline surface-antigen-negative and without prophylaxis) experienced donor-transmitted hepatitis B infection 10 months after transplantation that was treated with lamivudine. Two patients (baseline surface-antibody-negative) had hepatitis B seroconversion, becoming surface-antibody positive without evidence of infection. None of the 5 patients who received prophylaxis with lamivudine had donor-transmitted hepatitis, and only 1 lamivudine-treated patient had surface antibodies. Post-transplant survival in this small cohort was similar to that for all patients who underwent transplantation at our center during this time period.

CONCLUSIONS:

Transplantation of hearts from donors with hepatitis-B core antibodies is associated with a small viral-transmission risk, with or without post-transplant, anti-viral prophylaxis. Use of these donor hearts should be considered safe and may help to augment the available donor pool.

PMID:
15653376
[PubMed - indexed for MEDLINE]
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