Journal of hepatology · 2008
Anti-HBs re-seroconversion after liver transplantation in a patient with past HBV infection receiving a HBsAg positive graft.
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Loggi Elisabetta, Bihl Florian, Chisholm John V, Biselli Maurizio, Bontadini Andrea, Vitale Giovanni, Ercolani Giorgio, Grazi Gian Luca, Pinna Antonio D, Bernardi Mauro, Brander Christian, Andreone Pietro
Аннотация
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.
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.