TY - JOUR T1 - De novo hepatitis B virus infection from anti-HBc-positive donors in pediatric living donor liver transplantation. JF - Journal of digestive diseases// J Dig Dis Y1 - 2013 A1 - Xi, Zhi Feng A1 - Xia, Qiang A1 - Zhang, Jian Jun A1 - Chen, Xiao Song A1 - Han, Long Zhi A1 - Zhu, Jian Jun A1 - Wang, Si Yue A1 - Qiu, De Kai KW - *Hepatitis B Core Antigens/bl [Blood] KW - *Hepatitis B/tm [Transmission] KW - *Liver Transplantation/ae [Adverse Effects] KW - *Living Donors KW - Antiviral Agents/tu [Therapeutic Use] KW - Child, Preschool KW - Female KW - Hepatitis B Vaccines KW - Hepatitis B virus/ip [Isolation & Purification] KW - Hepatitis B/pc [Prevention & Control] KW - Hepatitis B/vi [Virology] KW - Humans KW - Infant KW - Male KW - Retrospective Studies KW - Risk Factors AB - OBJECTIVE: The aim of this study was to analyze the incidence and risk factors of de novo hepatitis B virus (HBV) infection from hepatitis B core antibody (anti-HBc)-positive donors in pediatric living donor liver transplantation (LDLT)., METHODS: We retrospectively analyzed 46 recipients without pre-liver transplantation (LT) HBV infection evidence who underwent LDLT from October 2006 to May 2011 in our center. HBV markers, including hepatitis B surface antigen (HBsAg) and antibody (anti-HBs), anti-HBc, hepatitis B e antigen (HBeAg) and antibody (anti-HBe) were determined in both donors and recipients before LT and in recipients after LT. HBV DNA titer was measured if the recipients were strongly suspected of de novo HBV infection., RESULTS: Without prophylaxis, de novo HBV infection occurred in 11 of 46 recipients (23.9%) 6-36 months after LT. All 11 patients received grafts from anti-HBc-positive donors. The donors' baseline status and the characteristics of recipients at the time of transplantation were not associated with the acquisition of de novo hepatitis B infection. The overall 2-year survival rate of patients from anti-HBc-positive donors was 84.2%. Two de novo HBV-infected patients who had YMDD mutation were given adefovir combined with lamivudine, and their liver function gradually improved during the follow-up period., CONCLUSIONS: Anti-HBc-positive donors can significantly increase the incidence of de novo HBV infection in HBsAg-negative recipients. Administration with adefovir in patients who are resistant to lamivudine seems to be an effective and safe way for de novo HBV infection.Copyright © 2013 Wiley Publishing Asia Pty Ltd and Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine. M1 - 101302699 CY - Australia VL - 14 SN - 1751-2980 CP - 8 L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=medl&NEWS=N&AN=23638710 ID - 4495 ER -