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Use of hepatitis B surface antigen-positive grafts in liver transplantation: a matched analysis of the US National database.
- Source :
-
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society [Liver Transpl] 2014 Jan; Vol. 20 (1), pp. 35-45. Date of Electronic Publication: 2013 Dec 12. - Publication Year :
- 2014
-
Abstract
- The scarcity of available donor organs is the key challenge in orthotopic liver transplantation (OLT). A viable way of expanding the donor pool is the use of liver grafts from hepatitis B surface antigen (HBsAg)-positive donors. The present study used the US Scientific Registry of Transplant Recipients database (1987-2010), and each of the 78 patients who underwent OLT with HBsAg-positive grafts was matched with 4 patients who received HBsAg-negative grafts by urgent status, donor sex, recipient sex, donor age, recipient age, transplant date, Model for End-Stage Liver Disease score, and warm ischemia time. The overall graft and patient survival rates were similar for recipients of HBsAg-positive grafts and matched controls: the 5-year graft survival rates were 66% and 64%, respectively (P = 0.95), and the 5-year patient survival rates were 71% and 71%, respectively (P = 0.87). A Cox proportional hazards regression analysis that was adjusted for other variables showed no impact of the donor HBsAg status on graft or patient survival. The use of hepatitis B immunoglobulin (HBIG) was independently associated with better posttransplant graft survival [hazard ratio (HR) = 0.23, 95% confidence interval (CI) = 0.06-0.81] and patient survival (HR = 0.16, 95% CI = 0.04-0.75) for recipients of HBsAg-positive grafts. In conclusion, the use of HBsAg-positive liver grafts did not reduce posttransplant graft or patient survival. Moreover, matching these donors to recipients treated with HBIG may improve safety.<br /> (© 2013 American Association for the Study of Liver Diseases.)
- Subjects :
- Adolescent
Adult
Cohort Studies
Databases, Factual
End Stage Liver Disease mortality
Female
Graft Survival
Humans
Male
Matched-Pair Analysis
Middle Aged
Proportional Hazards Models
Registries
Severity of Illness Index
Treatment Outcome
United States
Warm Ischemia
Young Adult
End Stage Liver Disease therapy
Hepatitis B Surface Antigens immunology
Liver immunology
Liver Transplantation
Subjects
Details
- Language :
- English
- ISSN :
- 1527-6473
- Volume :
- 20
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
- Publication Type :
- Academic Journal
- Accession number :
- 24142889
- Full Text :
- https://doi.org/10.1002/lt.23774