Kidney transplant from donors with hepatitis B: A challenging treatment option.
Hepatitis B virus
Kidney transplant
Long term outcomes
Organ donor
Recipient allocation
Transmission
Journal
World journal of hepatology
ISSN: 1948-5182
Titre abrégé: World J Hepatol
Pays: United States
ID NLM: 101532469
Informations de publication
Date de publication:
27 Aug 2021
27 Aug 2021
Historique:
received:
24
02
2021
revised:
22
06
2021
accepted:
29
07
2021
entrez:
23
9
2021
pubmed:
24
9
2021
medline:
24
9
2021
Statut:
ppublish
Résumé
Utilizing kidneys from donors with hepatitis B is one way to alleviate the current organ shortage situation. However, the risk of hepatitis B virus (HBV) transmission remains a challenge that undermines the chance of organs being used. This is particularly true with hepatitis B surface antigen (HBsAg) positive donors despite the comparable long-term outcomes when compared with standard donors. To reduce the risk of HBV transmission, a comprehensive approach is needed. This includes assessment of donor risk, optimal allocation to the proper recipient, appropriate immunosuppressive regimen, optimizing the prophylactic therapy, and post-transplant monitoring. This review provides an overview of current evidence of kidney transplants from donors with HBsAg positivity and outlines the challenge of this treatment. The topics include donor risk assessment by adopting the nucleic acid test coupled with HBV DNA as the HBV screening, optimal recipient selection, importance of hepatitis B immunity, role of nucleos(t)ide analogues, and hepatitis B immunoglobulin. A summary of reported long-term outcomes after kidney transplantation and proposed criteria to utilize kidneys from this group of donors was also defined and discussed.
Identifiants
pubmed: 34552692
doi: 10.4254/wjh.v13.i8.853
pmc: PMC8422915
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
853-867Informations de copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict-of-interest statement: The authors declare no conflict of interest.
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