Transplanting hepatitis B surface antigen-positive livers in the United States: Outcomes and opportunities

Livers from donors with positive hepatitis B surface antigens (HBsAg+) have been used to expand the donor pool; however, outcome data are limited. We aim to evaluate survival following liver transplant (LT) from HBsAg+ donors. Using the United Network for Organ Sharing registry, we identified HBsAg+ donors used for LT from 2009 to 2020. We used Kaplan-Meier survival and Cox proportional hazards regression to compare post-LT survival in hepatitis B virusnegative recipients who utilized HBsAg+ donors to propensity-matched cohorts who utilized other types of donors. From 2009-2020, 70 patients received HBsAg+ livers, and 58 of them did not carry a diagnosis of chronic hepatitis B virus. The 1- and 3-year post-LT survival for hepatitis B virus-negative patients who received livers from HBsAg+ donors were 96.6% and 91.4%, respectively, with no statistical differences compared with patients who received livers from hepatitis C virus viremic donors (96.5%/93.0%, P =.961/.427), donation after cardiac death donors (93.0%/86.0%, P =.651/.598), average-risk donors (89.5%/86.0%, P = 0.264/0.617),

Automated summary

The study evaluated the survival rate of patients who received liver transplants from donors with positive hepatitis B surface antigens (HBsAg+). Data from the United Network for Organ Sharing registry was used to compare the post-transplant survival of patients who received HBsAg+ livers with those who received livers from other types of donors. The results showed that there were no statistical differences in survival rates between patients who received HBsAg+ livers and those who received livers from other types of donors.