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J Gastroenterol Hepatol. 2019 Oct 14. doi: 10.1111/jgh.14869. [Epub ahead of print]

Risk factors of de novo hepatitis B virus infection in pediatric hepatitis B core antibody positive liver graft recipients under prophylactic therapy.

Dong C1,2, Song Z1,2, Chen J1,2, Ma N1,2, Meng X1,2, Sun C1,2, Duan K3, Bi B3, Wang K1,2, Qin H1,2, Han C1,2, Yang Y1,2, Zhang F1,2, Zheng W1,2, Gao W1,2.

Author information

1
Organ Transplantation Center, Tianjin First Central Hospital, Tianjin, China.
2
Tianjin Key Laboratory for Organ Transplantation, Tianjin, China.
3
Biological Sample Resource Sharing Center, Tianjin First Central Hospital, Tianjin, China.

Abstract

BACKGROUND AND AIM:

We aim to investigate the risk factors of de novo hepatitis B virus (HBV) infection in pediatric liver transplantation recipients receiving hepatitis B core antibody positive grafts and to evaluate the efficacy of our prophylactic strategies.

METHODS:

One hundred thirty-nine pediatric recipients receiving hepatitis B core antibody positive grafts operated from September 2016 to September 2018 were retrospectively enrolled, and all the patients received prophylactic treatment to prevent de novo HBV infection. Donor and recipient features, operative information along with graft, and recipient outcomes were compared between recipients with or without de novo HBV infection. Univariate and multivariate analyses were applied to identify the risk factors of de novo HBV infection.

RESULTS:

The mean follow-up time was 23.5 ± 15.7 months, and the overall incidence of de novo HBV infection was 3.6%. Recipients with de novo HBV infection showed equal graft and recipient outcome compared with the recipients without de novo HBV infection during the follow-up time. Recipient preoperative hepatitis B surface antibody titer of < 1000 IU/L (odds ratio [OR] = 9.652, P = 0.024), graft HBV DNA of > 1000 copies (OR = 9.050, P = 0.032), and intraoperative fresh-frozen plasma transfusion of > 400 mL (OR = 10.462, P = 0.023) were identified as independent risk factors for de novo HBV infection.

CONCLUSION:

Hepatitis B core antibody positive grafts can safely be used in pediatric liver transplantation under rational prophylactic therapy.

KEYWORDS:

de novo hepatitis B; hepatitis B core antibody; hepatitis B surface antibody; pediatric liver transplantation

PMID:
31609494
DOI:
10.1111/jgh.14869

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