Kidney Transplantation From Hepatitis B Virus Core Antibody-Positive Donors: Prophylaxis With Hepatitis B Immunoglobulin

OBJECTIVE: Hepatitis B virus core antibody (HBcAb)-positive organ donors have thepotential to transmit infection to transplant recipients.PATIENTS AND METHODS: We investigated the use of a single dose of 2000 IU ofhepatitis B immunoglobulin in 18 patients among a population of 54 kidneytransplant recipients from HBcAb-positive deceased donors.RESULTS: Twelve recipients were HBcAb-positive before transplantation. Among the other 42 patients, 5 (11.9%) seroconverted from HBcAb-negative to HBcAb-positive,whereas one HBcAb-positive recipient became hepatitis B virus surfaceantigen-positive with clinical signs of active hepatitis 6 years aftertransplantation. In the 18 patients who underwent prophylaxis, we did not findany seroconversion or hepatitis B virus (HBV) transmission. Graft and patientsurvival of HBcAb-positive kidney transplants did not differ significantly with amatched population of HBcAb-negative transplantation.CONCLUSION: These results suggest that kidney transplantation from HBcAb-positivedonors is safe with a low rate of HBV transmission. A prophylaxis with a singleshot of hepatitis B immunoglobulin may be effective in reducing the risk of HBVseroconversion or reactivation and may be suggested in all naïve orHBcAb-positive transplant recipients.