Pre-transplant donor HBV DNA+ and male recipient are independent risk factors for treatment failure in HBsAg+ donors to HBsAg- kidney transplant recipients
机构：[1]Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Number 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.[2]Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.[3]Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.[4]Department of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China.[5]West China School of Clinical Medicine, Sichuan University, Chengdu, Sichuan, China.[6]Department of Health Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China.[7]Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Number 37, Guoxue Alley, Chengdu, 610041, Sichuan, China. kidney5@163.com.[8]Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China. kidney5@163.com.
Background: In order to reduce the burden on organ shortage around the world, using potential infectious donor might be an option. However, scarce evidences have been published on kidney transplantation (KTx) from hepatitis B surface antigen (HBsAg) + donors to HBsAg- recipients [D (HBsAg+)/R(HBsAg-)] without hepatitis B virus (HBV) immunity. Here, we reported the results of D(HBsAg+/HBV DNA- or +)/R(HBsAg-) living KTx recipients with or without HBV immunity.
Methods: We retrospectively identified 83 D(HBsAg+)/R(HBsAg-) living KTx recipients, and 83 hepatitis B core antibody (HBcAb) + living donors to HBcAb- recipients [D(HBcAb+)/R(HBcAb-)] were used as control group by reviewing medical archives and propensity score matching. Treatment failure (defined as any HBV serology conversion, liver injury, graft loss, or recipient death) is the primary endpoint.
Results: Twenty-four donors (28.9%) were HBV DNA+, and 20 recipients had no HBV immunity in the D(HBsAg+)/R(HBsAg-) group pre-transplantation. HBV prophylaxis was applied in all D(HBsAg+)/R(HBsAg-) recipients, while none was applied in the D(HBcAb+)/R(HBcAb-) group. We observed a significant higher treatment failure in D(HBsAg+)/R(HBsAg-) than D(HBcAb+)/R(HBcAb-) group (21.7% vs. 10.8%, P < 0.001). Interestingly, no significant difference was found between groups on HBV seroconversion, liver and graft function, rejection, infection, graft loss, or death. However, 2/20 recipients without HBV immunity in the D(HBsAg+)/R(HBsAg-) group developed HBV DNA+ or HBsAg+, while none observed in the D(HBcAb+)/R(HBcAb-) group. HBV DNA+ donor and male recipient were significant risk factors for treatment failure.
Conclusion: D(HBsAg+)/R(HBsAg-) should be considered for living kidney transplantation, but with extra caution on donors with HBV DNA+ and male candidates.
语种：
中文
PubmedID：
中科院(CAS)分区：
出版当年[2021]版：
大类|3 区医学
小类|3 区传染病学
最新[2023]版：
大类|3 区医学
小类|3 区传染病学
第一作者：
第一作者机构：[1]Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Number 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.[2]Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
通讯作者：
通讯机构：[*1]Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Number 37, Guoxue Alley, Chengdu, 610041, Sichuan, China[7]Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Number 37, Guoxue Alley, Chengdu, 610041, Sichuan, China. kidney5@163.com.[8]Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China. kidney5@163.com.
推荐引用方式(GB/T 7714)：
王显丁,冯师健,刘金鹏,等.Pre-transplant donor HBV DNA+ and male recipient are independent risk factors for treatment failure in HBsAg+ donors to HBsAg- kidney transplant recipients[J].BMC Infectious Diseases.2021,21(1):
