Review
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World J Gastroenterol. Jun 21, 2014; 20(23): 7434-7441
Published online Jun 21, 2014. doi: 10.3748/wjg.v20.i23.7434
Hepatitis B transmission by cell and tissue allografts: How safe is safe enough?
Pilar Solves, Vicente Mirabet, Manuel Alvarez
Pilar Solves, Vicente Mirabet, Manuel Alvarez, Blood Bank, Hospital Universitari I Politècnic La Fe, Bulevar Sur, 46026 Valencia, Spain
Author contributions: Mirabet V and Alvarez M exhaustively reviewed the literature and wrote the paper; Solves P wrote the paper and critically reviewed it.
Correspondence to: Pilar Solves, MD, Blood Bank, Hospital Universitari I Politècnic La Fe, Bulevar Sur, 46026 Valencia, Spain. solves_pil@gva.es
Telephone: +34-96-3868142 Fax: +34-96-3502469
Received: October 28, 2013
Revised: January 4, 2014
Accepted: February 17, 2014
Published online: June 21, 2014
Abstract

More than 2 million human tissue transplants (bone, tendon, cartilage, skin, cornea, amniotic membrane, stem cells, heart valve, blood vessel, etc.), are performed worldwide every year. Cells and tissues are shared between countries which have different regulations and laboratory equipment and represent a risk of hepatitis B virus (HBV) transmission that has become a global safety concern. While the risk of transfusion-transmitted HBV infection from blood donations has been estimated, the rate of HBV transmission from donors to recipients of allografts is unknown and varies between different tissues. There are various important ways of reducing the transmission risk, but donor screening and donor testing are still the main factors for preventing HBV transmission. HBV detection is included in the routine screening tests for cell and tissue donors. The standard test for preventing transplant-transmitted hepatitis B is the hepatitis B surface antigen. The implementation of methods involving nucleic acid amplification and the new generation of reactives to detect viral antibodies or antigens with an immunoassay, has increased the sensitivity and the specificity of the screening tests. The objective of our research was to review the literature and critically analyse the different steps for avoiding HBV transmission in cell and tissue donors, focusing on the screening tests performed.

Keywords: Hepatitis B virus, Tissue bank, Tissue transplantation

Core tip: Human tissue transplantation is a current practice that still represents a risk for hepatitis B virus transmission (HBV). HBV detection is included in the routine screening tests for cell and tissue donors. The implementation of methods involving nucleic acid amplification has increased the sensitivity and specificity of the screening tests. The aim of this review is to update the knowledge of the risk of hepatitis transmission through tissue transplantation and critically analyze current screening tests.