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• W4362587328 abstract "PurposeDue to wide shortage of organs, prolonged wait times, and increased mortality among patients awaiting heart transplantation, recent attention has been given for ways to expand the donor pool. Grafts from hepatitis B-positive donors are often declined due to concerns regarding infection. This study aims to analyze and determine the short- and long-term outcomes of orthotopic heart transplantation of grafts from hepatitis B-positive donors, and evaluate the risk of disease transmission following transplant.In our institution, if the donor is hepatitis B-core antibody positive and the recipient's hepatitis B surface antibody (HBsAb) is positive, no further treatment is required. If the recipient's HBsAb is negative, the patient receives antiviral prophylaxis for one year post-transplant. Hepatitis B surface antigen is then checked one year post-transplant.MethodsA retrospective chart review was performed to identify heart transplant recipients who received a donor hepatitis B-core antibody positive graft. The primary outcome was overall survival. Graft function, rates of seroconversion at 1, 2, and 3 years, and rates and duration of prophylaxis were also recorded.ResultsOf 1,994 OHTs at a single institution from 2000 to 2022, 30 recipients received HBcAb-positive grafts. The median follow-up time was 34.9 months. Mean recipient age at transplant was 58.4 years. Median transplant waitlist time was 118 days. The 1- and 2-year overall survival rate was 89.8%, and the 3-year overall survival rate was 84.2%. 21 patients (70%) received antiviral prophylaxis against hepatitis B, and the median duration of therapy was 12 months. None of the patients had newly positive hepatitis B serologies at 1, 2, or 3 years post-transplant. Only 1 patient (3.3%) experienced graft loss.ConclusionHepatitis B-core positive status of donors does not substantially affect recipient outcomes after orthotopic heart transplantation. Increased use of such grafts could expand donor pools and decrease mortality associated with long waitlist times. Due to wide shortage of organs, prolonged wait times, and increased mortality among patients awaiting heart transplantation, recent attention has been given for ways to expand the donor pool. Grafts from hepatitis B-positive donors are often declined due to concerns regarding infection. This study aims to analyze and determine the short- and long-term outcomes of orthotopic heart transplantation of grafts from hepatitis B-positive donors, and evaluate the risk of disease transmission following transplant. In our institution, if the donor is hepatitis B-core antibody positive and the recipient's hepatitis B surface antibody (HBsAb) is positive, no further treatment is required. If the recipient's HBsAb is negative, the patient receives antiviral prophylaxis for one year post-transplant. Hepatitis B surface antigen is then checked one year post-transplant. A retrospective chart review was performed to identify heart transplant recipients who received a donor hepatitis B-core antibody positive graft. The primary outcome was overall survival. Graft function, rates of seroconversion at 1, 2, and 3 years, and rates and duration of prophylaxis were also recorded. Of 1,994 OHTs at a single institution from 2000 to 2022, 30 recipients received HBcAb-positive grafts. The median follow-up time was 34.9 months. Mean recipient age at transplant was 58.4 years. Median transplant waitlist time was 118 days. The 1- and 2-year overall survival rate was 89.8%, and the 3-year overall survival rate was 84.2%. 21 patients (70%) received antiviral prophylaxis against hepatitis B, and the median duration of therapy was 12 months. None of the patients had newly positive hepatitis B serologies at 1, 2, or 3 years post-transplant. Only 1 patient (3.3%) experienced graft loss. Hepatitis B-core positive status of donors does not substantially affect recipient outcomes after orthotopic heart transplantation. Increased use of such grafts could expand donor pools and decrease mortality associated with long waitlist times." @default.
• W4362587328 created "2023-04-06" @default.
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• W4362587328 date "2023-04-01" @default.
• W4362587328 modified "2023-09-23" @default.
• W4362587328 title "(573) Outcomes of Hepatitis B Virus-Infected Donors in Heart Transplantation" @default.
• W4362587328 doi "https://doi.org/10.1016/j.healun.2023.02.588" @default.
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