Journal
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
Volume 37, Issue 6, Pages 1052-1059Publisher
WILEY
DOI: 10.1111/jgh.15821
Keywords
donor shortage; extended criteria donor; HBsAg positive donor; liver transplantation; propensity score matching
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Funding
- Zhejiang Provincial Natural Science Foundation of China [LY20H160023]
- Research Unit Project of Chinese Academy of Medical Sciences [2019-12M-5-030]
- Health Commission of Zhejiang Province [JBZX-202004]
- National Natural Science Foundation of China [81970552]
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The outcomes of liver transplantation using HBsAg+ grafts are comparable to those using HBsAg- grafts, providing strong evidence for the safe use of HBsAg+ grafts in expanding the donor liver pool.
Background and Aim Donor shortage has become worldwide limitation in liver transplantation (LT). Use of hepatitis B virus surface antigen positive (HBsAg+) donors could be an alternative source of donor organs. This study aims to investigate the safety and efficacy of LT using HBsAg+ liver grafts and associated long-term outcome. Methods This was a retrospective study of adults LT registered in the database of the China Liver Transplant Registry between January 2015 and September 2018. By propensity score matching (1:1), 503 eligible patients who received HBsAg+ liver grafts were compared with 503 matched patients who received HBsAg- liver grafts. Results The 1-, 3-, and 5-year patient survival rates were 81.52%, 72.04%, and 66.65% in HBsAg+ donor group, which were comparable with 83.93%, 77.27%, and 65.73% in HBsAg- donor group (P = 0.222). The 1-, 3-, and 5-year graft survival rates were also comparable between the two groups (81.49%, 71.45%, and 67.26% vs 83.62%, 77.11%, and 65.81%, respectively, P = 0.243). Most main complications were not increased in HBsAg+ donor group except for the retaining of HBsAg positivity after LT. Furthermore, transplanting HBsAg+ liver grafts did not result in inferior outcomes either in HBsAg+ or HBsAg- recipients. The risk of tumor recurrence after LT was not increased in hepatocellular carcinoma patients. Conclusions The outcomes of using HBsAg+ liver grafts were comparable with those of HBsAg- liver grafts. Our study provided strong evidence for the safe use of HBsAg+ grafts in LT to expand the donor liver pool.
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