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

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• 作者：Elisabetta Loggi ; Florian Bihl ; John V. Chisholm III ; Maurizio Biselli ; Andrea Bontadini ; Giovanni Vitale ; Giorgio Ercolani ; Gian Luca Grazi ; Antonio D. Pinna ; Mauro Bernardi ; Christian Br ; er ; Pietro
• 关键词：Orthotopic liver transplantation ; HBsAg positive marginal graft ; Humoral immunity ; T cell immunity ; Organ shortage
• 刊名：Journal of Hepatology
• 出版年：2009
• 出版时间：March 2009
• 年：2009
• 卷：50
• 期：3
• 页码：625-630
• 全文大小：161 K

文摘

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.