Low prevalence of HBV DNA in the liver allograft from anti-HBc-positive donors: a single-center experience

Allografts from donors positive for antibody to hepatitis B core antigen (anti-HBc+) can transmit hepatitis B virus (HBV) to the recipients. We aimed to study the prevalence of HBV DNA in liver allografts from anti-HBc+ donors. Between January 2003 and December 2008, this retrospective study identified 18 patients who received a liver from an anti-HBc+ donor. Pre- and post-transplantation HBV serology and serum HBV DNA level of the study subjects were reviewed. DNA extracted from liver biopsy tissue was used for PCR assay. Immunohistochemistry was also performed to determine viral protein expression. We observed a low prevalence of HBV DNA in allografts from anti-HBc+ donors even among patients who did not receive prophylaxis. Only one of 18 patients had detectable HBV DNA in the liver allograft. This recipient was seronegative for HBV before transplantation and did not receive prophylaxis after transplantation, and developed de novo hepatitis B. Of the five patients who were positive for both antibody to hepatitis B surface antigen and anti-HBc before transplantation and did not receive prophylaxis after transplantation, none developed HBV infection. Prophylaxis for HBV is important for seronegative recipients receiving a liver from an anti-HBc+ donor. Such prophylaxis may not be necessary for recipients who do not have detectable HBV DNA in the liver allograft.