Transmission of hepatitis B by transplantation of livers from donors positive for antibody to hepatitis B core antigen

R. C. Dickson, J. E. Everhart, J. R. Lake, Y. Wei, E. C. Seaberg, R. H. Wiesner, R. K. Zetterman, T. L. Pruett, M. B. Ishitani, J. H. Hoofnagle, K. M. Detre, A. J. Demetris, S. Belle, Y. Wei, M. Lombardero, E. Seaberg, S. Lawlor, H. Eng, S. Fitzgerald, J. HaberG. L. Swanson, R. Wiesner, R. Krom, M. K. Porayko, L. Schwerman, C. Groettum, R. K. Zetterman, Jr Shaw B., K. Taylor, N. Ascher, J. Lake, C. Bremer-Kamp, J. Everhart, S. Shores

Research output: Contribution to journalArticlepeer-review

389 Scopus citations


Background and Aims: Organ donors are a potential source of transmissible disease after transplantation. The aim of this study was to evaluate the risk of acquiring hepatitis B among transplantation recipients of livers from donors without serum hepatitis B surface antigen (HBsAg) but with antibody to hepatitis B core antigen (anti-HBc). Methods: The transplantation experience of four centers between 1989 and 1994 was reviewed. Recipients of livers from 674 donors were considered informative for hepatitis B virus transmission. Results: Hepatitis B developed in 18 of 23 recipients of livers from anti-HBc-positive donors (78%) compared with only 3 of 651 recipients of anti-HBc-negative donor livers (0.5%) (P < 0.0001). HBsAg persisted in all recipients with donor-related hepatitis B. Liver histology showed chronic hepatitis of moderate severity in 2 of 13 recipients at 1 year and 5 of 8 recipients between 1.6 and 4.5 years from transplantation. Liver transplantation from an anti-HBc-positive donor was associated with decreased 4-year survival (adjusted mortality hazard ratio of 2.4; 95% confidence interval, 1.44.0). Conclusions: De novo posttransplantation hepatitis B infection occurs at a high rate in recipients of donors with anti-HBc. Transmission of hepatitis B through transplantation suggests that the virus may persist in the liver despite serological resolution of infection.

Original languageEnglish (US)
Pages (from-to)1668-1674
Number of pages7
Issue number5
StatePublished - 1997


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