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Outcomes of Entecavir Prophylaxis in Hepatitis B Immune Patients Receiving Hepatitis B Infected Kidneys: A Single Center Experience

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Abstract

Purpose of Review

Hepatitis B (HBV) vaccinated patients have mixed responses with regard to antibody titers and subsequent level of immunity. This review aims to examine the diverse strategies employed by transplant centers for infection prevention when utilizing HBV-infected kidneys, including our own center’s practice.

Recent Findings

Transplant centers have implemented varied prophylaxis approaches based on recipients’ anti-HB titers for utilizing HBV-infected kidneys. We retrospectively reviewed ten recipients who received kidneys from HBV-positive donors at our center. Recipients with anti-HBs titers above 100 mIU/mL received entecavir prophylaxis, while those with lower titers received perioperative HBIG. Throughout the follow-up, all patients remained negative for HBV NAT and HBsAg. Six patients experienced asymptomatic anti-HBc seroconversion, of which two patients cleared anti-HBc within 1 year. One patient experienced a decline in anti-HBs titers below 100 mIU/mL but remained free of HBV infection.

Summary

The utilization of Hepatitis B-infected kidneys for transplantation in HBV-immunized recipients is safe. Asymptomatic seroconversion is frequent, but viremia is prevented by immunization and/or entecavir. The role of HBIG prophylaxis is unclear. Most patients with preoperative anti-HBs titer > 100 mIU/mL maintain those titers during the first-year post-transplant.

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Data Availability

Direct URL citations appear in the printed text. Supporting information can be found online in the supporting information section at the end of this article.

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Authors and Affiliations

  1. Medical City Fort Worth, Fort Worth, TX, USA

    Sameera Muqueet, Anna Curtis & Ashraf Reyad

  2. HCA Healthcare Research Institute North Texas Division, Fort Worth, TX, USA

    Nikhil A. Reddy

  3. PPG Health, Fort Worth, TX, USA

    Machaiah Madhrira & Sridhar R. Allam

Authors
  1. Sameera Muqueet
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  2. Nikhil A. Reddy
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  3. Anna Curtis
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  4. Machaiah Madhrira
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  5. Sridhar R. Allam
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  6. Ashraf Reyad
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Contributions

Authors S. M., A. R., and N. R. wrote the manuscript. All authors reviewed the manuscript.

Corresponding author

Correspondence to Ashraf Reyad.

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Ethics Approval and Consent to Participate

This study was approved by Medical City Healthcare Institutional Review Board as part of Master Retrospective Protocol Medical City Outcomes Research (MCOR-01). Informed consent from patients was not obtained as this was a retrospective study using deidentified data.

Competing Interests

The authors declare no competing interests.

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Muqueet, S., Reddy, N.A., Curtis, A. et al. Outcomes of Entecavir Prophylaxis in Hepatitis B Immune Patients Receiving Hepatitis B Infected Kidneys: A Single Center Experience. Curr Transpl Rep 11, 15–19 (2024). https://doi.org/10.1007/s40472-023-00425-1

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  • DOI: https://doi.org/10.1007/s40472-023-00425-1

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