The risks of HBV infection after liver transplantation from HBc antibody positive donor to HBs antibody positive recipient

The rate of de novo hepatitis B infection, after liver transplantation from a hepatitis B core antibody (HBcAb) (+) donor to a surface antibody (HBsAb) (+) recipient bas not yet elucidated. Four recipients with HBsAb (+) and HBcAb, (+), who received living donor grafts from HBcAb (+) donors were herein reviewed. They received lamivudine monotherapy: three patients with HBsAb titer >10 IU/L did not demonstrate the onset of HBsAg, whereas one patient with HBsAb titer <10 IU/L developed hepatitis B antigen (HBsAg) 4 years after transplantation. An HBsAb (+) patient with a titer of >10 IU/L is therefore considered not to require combination therapy when receiving an HBcAb (+) liver graft. However, a great deal of caution is necessary in patients with a negative or low HBsAb titers <10 IU/L.