Long term follow-up and outcome of liver transplantation from hepatitis B surface antigen positive donors

doi:10.3748/wjg.v23.i12.2095

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World Journal of Gastroenterology

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Mar 28, 2017; 23(12): 2095-2105
Published online Mar 28, 2017. doi: 10.3748/wjg.v23.i12.2095

Table 1 Recipient characteristics at the time of liver transplantation

Case	Age	Gender	AB0	BMI	Indication	Real MELD	MELD correct	UNOS	Wating List(d)	Year LT	HCC criteria	Downstaging type (No.)
1	62	M	0	27	HCC/HBV	26	36	2A	37	2007	MILAN IN	LOC(1)¹
2	65	M	B	21	HCC/HBV	16	39	3	522	2007	MILAN IN	LOC(1) + SUR(1)
3	54	M	A	22	HCC/HBV	10	33	3	513	2007	MILAN IN	LOC(1)
4	45	M	A	24	HCC/HBV	14	34	2B	419	2007	MILAN OUT	LOC (3)
5	62	M	0	29	HCC/HBV	12	33	3	445	2008	MILAN OUT	LOC (2)
6	53	M	0	28	HCC/HBV	12	35	2B	515	2008	MILAN IN	LOC (1)
7	45	M	A	23	HCV/HBV	24	24	2A	101	2005
8	64	M	B	27	HBV/HCV	33	33	2A	478	2005
9	26	M	A	23	HBV	23	23	2B	742	2005
10	64	M	A	22	HCC/HBV	11	23	2B	144	2005	MILAN IN	LOC (2)
11	65	F	B	25	HCC/HBV	12	24	2A	195	2006	MILAN IN	LOC (2)
12	56	M	A	24	HCC/HBV	10	24	2B	217	2006	MILAN OUT	LOC (5)
13	61	F	0	23	HCC/HBV	14	30	2B	352	2006	MILAN IN	LOC (2)
14	59	M	A	24	HBV	30	30	2B	118	2007
15	48	F	A	27	CBS	21	33	2A	82	2007
16	65	M	A	24	HCC/HBV	8	25	2B	358	2009	MILAN IN	LOC (2)
17	57	M	A	30	HCC/HBV	14	39	2B	576	2009	MILAN OUT	LOC (7)
18	55	M	B	28	HCC/HBV	18	26	2B	38	2009	MILAN IN	LOC (3)
19	65	M	A	24	HCC/HBV	7	25	2B	371	2009	MILAN IN	LOC (3)
20	63	M	A	28	HCC/HBV	16	25	2B	1962	2010	MILAN IN	LOC (2)
21	60	M	A	34	HCC/HBV	10	27	2B	330	2010	MILAN OUT	LOC (1) + SUR (1)
22	61	M	A	24	HBV	11	11	3	855	2010
23	67	M	0	19	HBV	16	16	2B	742	2004
24	55	M	A	24	HBV	17	17	3	127	2004
25	60	F	0	29	HBV/HCV	17	17	2B	961	2004
26	55	M	A	26	HCC/HBV	10	20	3	748	2005	MILAN IN	LOC (1)
27	54	M	A	27	HCC/HBV	13	19	3	134	2006	MILAN OUT	LOC (2)
28	67	M	0	22	HCC/HBV	12	29	3	575	2009	MILAN IN	LOC (1) + SUR (1)

¹LOC: Locoregional therapy [transcatheter arterial chemoembolization (TACE) and/or radiofrequency ablation (RITA)]. SUR: Surgery; MELD: Model for end-stage disease; BMI: Body mass index; LT: Liver transplantation; HCC: Hepatocellular carcinoma; CBS: Secondary biliary cirrhosis; HCV: Hepatitis C virus.

Table 2 Recipient characteristics n (%)

Recipient variables	n = 28
Transplant center (No. of patients)
Modena	6 (21.4)
Bologna	16 (57.1)
Padova	6 (21.4)
Gender
Male	24 (85.7)
Female	4 (14.3)
AB0 blood group
Isogroup	28 (100)
0	7 (25)
A	17 (60.7)
B	4 (14.3)
Age (yr), mean (range, SD)	57.6 (26-67, ± 8.7)
Body mass index, mean (range, SD)	25.3 (19-34, ± 3.1)
Real MELD score, mean (range, SD)	15.6 (7-33, ± 6.5)
Correct MELD score, mean (range, SD)	26.7 (11-39, ± 7.2)
UNOS status
2A	5 (17.5)
2B	15 (53.6)
3	8 (28.6)
Time waiting list (d), mean (range, SD)	452 (37-1962, ± 393.5)
Associated hepatocellular carcinoma	19 (69.7)
Meeting Milan criteria	13 (46.4)
Meeting UCSF criteria	6 (21.4)
HBsAg status
Positive	23 (82.1)
Negative	5 (17.9)
HBV DNA positive at LT	12 (52.1)
HCV co-infection	4 (14.3)
HDV co-infection	0

UCSF: University of California, San Francisco; LT: Liver transplantation; HCV: Hepatitis C virus; HDV: Hepatitis D virus; MELD: Model for end-stage disease.

Table 3 Donor characteristics

Case	Age	Gender	AB0 Gr.	BMI (kg/m²)	Cause of death	Time ICU (d)	Sodium (mEq/mL)	Vasopressors	Histologic activity index		Graft steatosis macro
Case	Age	Gender	AB0 Gr.	BMI (kg/m²)	Cause of death	Time ICU (d)	Sodium (mEq/mL)	Vasopressors	Grading	Staging	Graft steatosis macro
1	59	M	0	26	CH	2	165	No	1	0	20%
2	13	F	B	19	T	21	161	Yes	2	0	0%
3	69	M	A	24	CH	3	152	No	0	0	0%
4	72	F	A	27	CH	7	150	No	1	0	35%
5	66	M	0	22	CH	5	137	Yes	3	1	0%
6	60	M	0	26	CH	4	158	No	2	0	0%
7	73	M	A	26	CH	2	151	Yes	2	1	0%
8	51	M	B	23	CH	6	149	Yes	3	1	10%
9	54	M	A	24	T	13	160	Yes	2	1	10%
10	72	F	A	23	T	2	148	No	2	0	0%
11	60	F	B	29	CH	8	162	Yes	3	1	5%
12	65	M	A	29	CH	3	140	Yes	4	1	30%
13	50	M	0	24	CH	12	141	Yes	2	1	3%
14	48	M	A	23	T	2	143	No	4	1	5%
15	26	M	A	23	T	1	145	Yes	1	0	0%
16	52	F	A	28	CH	1	155	Yes	4	1	0%
17	79	F	A	24	CH	19	136	No	0	0	0%
18	46	F	B	29	CH	2	158	No	0	0	0%
19	61	M	A	29	CH	3	156	No	1	1	10%
20	53	F	A	25	CH	6	154	Yes	2	1	4%
21	44	F	A	24	CH	6	144	Yes	4	1	5%
22	23	F	A	21	other	7	149	Yes	1	1	0%
23	57	F	0	24	CH	4	147	Yes	0	0	0%
24	59	M	A	24	CH	1	160	Yes	0	0	5%
25	35	F	0	23	CH	1	140	Yes	1	0	0%
26	36	M	A	25	T	2	146	Yes	3	1	0%
27	23	M	A	29	T	2	147	Yes	0	0	0%
28	66	F	0	27	CH	3	151	Yes	1	0	10%

BMI: Body mass index; CH: Cerebral hemorrhage; T: Trauma; ICU: Intensive care unit.

Table 4 Serological state of the recipient/donor

Case	HBsAg	HBsAb	HBcAb	HBeAg	HBeAb	HBV DNA	HDV	HDV RNA	HCV Ab	Therapy pre-LT	Mutation
R1	+	-	+	-	+	-	-	-	-	Lam	No
D1	+	-	+	-	+	+	-	-	-	No	-
R2	+	-	+	-	+	-	-	-	-	Lam	No
D2	+	-	+	-	+	+	-	-	-	No	-
R3	+	-	+	-	+	+	-	-	-	Lam + Adef	Yes
D3	+	-	+	-	+	+	-	-	-	No	-
R4	+	-	+	+	-	-	-	-	-	Lam	No
D4	+	-	+	-	+	-	-	-	-	No	-
R5	+	-	+	-	+	+	-	-	-	Lam + Adef	Yes
D5	+	-	+	-	+	-	-	-	-	No	-
R6	+	-	+	-	+	-	+	-	-	Lam	No
D6	+	-	+	-	+	+	-	-	-	No	-
R7	-	+	+	-	-	-	-	-	+	No	No
D7	+	-	+	+	-	+	-	-	+	No	-
R8	-	+	+	-	-	-	-	-	+	No	No
D8	+	-	+	-	+	+	-	-	-	No	-
R9	+	-	+	+	-	+	-	-	-	Lam	No
D9	+	-	+	+	-	+	-	-	-	No	-
R10	+	-	+	-	+	-	-	-	-	Lam	No
D10	+	-	+	+	-	+	-	-	-	No	-
R11	-	+	+	-	-	-	-	-	+	No	No
D11	+	-	+	+	-	+	-	-	+	No	-
R12	+	+	+	-	+	+	-	-	-	Lam	No
D12	+	-	+	-	+	+	-	-	-	No	-
R13	+	-	+	-	+	-	-	-	-	Lam	No
D13	+	-	+	+	-	+	-	-	-	No	-
R14	+	-	+	-	+	+	-	-	-	Lam	No
D14	+	-	+	-	+	-	-	-	-	No	-
R15	-	-	+	-	+	-	-	-	-	No	No
D15	+	-	+	-	+	+	-	-	-	No	-
R16	+	-	+	-	+	+	-	-	-	Lam	No
D16	+	-	+	-	+	+	-	-	-	No	-
R17	+	-	+	-	+	+	-	-	-	Lam + Adef	Yes
D17	+	-	+	+	-	+	-	-	-	No	-
R18	+	-	+	-	+	+	-	-	-	Lam	No
D18	+	-	+	-	+	-	-	-	-	No	-
R19	+	-	+	+	-	+	-	-	-	Adefovir	No
D19	+	-	+	+	-	+	-	-	-	No	-
R20	+	-	+	-	+	+	-	-	-	Lam + Adef	No
D20	+	-	+	+	-	+	-	-	-	No	-
R21	+	-	+	-	+	-	-	-	-	NA	No
D21	+	-	+	+	-	+	-	-	-	No	-
R22	+	-	+	-	+	-	-	-	-	Lam	No
D22	+	-	+	+	-	+	-	-	-	No	-
R23	+	-	+	-	+	-	-	-	-	Lam	No
D23	+	-	+	-	+	-	-	-	-	No	-
R24	+	-	+	-	+	+	-	-	-	Lam	Yes
D24	+	-	+	-	+	-	-	-	-	No	-
R25	-	+	+	-	+	-	-	-	+	No	No
D25	+	-	+	-	+	-	-	-	-	No	-
R26	+	-	+	-	+	-	-	-	-	Lam	No
D26	+	-	+	+	-	+	-	-	-	No	-
R27	+	-	+	-	+	-	-	-	-	Adef	Yes
D27	+	-	+	-	+	+	-	-	-	No	-
R28	+	-	+	-	+	-	+	-	-	Lam	No
D28	+	-	+	+	-	+	-	-	-	No	-

R: Recipient; D: Donor; LT: Liver transplant; Lam: Lamivudine; Adef: Adefovir.

Table 5 Literature review

Ref.	Year	Cases
Franchello et al[46]	2005	3
Jiang et al[34]	2011	6
Loggi et al[37]	2012	10
Saidi et al[48]	2013	92
Choi et al[49]	2013	8
Li et al[39]	2013	78
Ju et al[50]	2013	23
Yu et al[51]	2014	42
Krishnamoorthi et al[47]	2014	28
Jeng et al[52]	2015	14

Citation: Ballarin R, Cucchetti A, Russo FP, Magistri P, Cescon M, Cillo U, Burra P, Pinna AD, Di Benedetto F. Long term follow-up and outcome of liver transplantation from hepatitis B surface antigen positive donors. World J Gastroenterol 2017; 23(12): 2095-2105
URL: https://www.wjgnet.com/1007-9327/full/v23/i12/2095.htm
DOI: https://dx.doi.org/10.3748/wjg.v23.i12.2095