TY - JOUR T1 - Renal transplantation from hepatitis B surface antigen (HBsAg)-positive donors to HBsAg-negative recipients: a case of post-transplant fulminant hepatitis associated with an extensively mutated hepatitis B virus strain and review of the current literature JF - Transplant infectious disease : an official journal of the Transplantation Society// // Transpl Infect Dis Y1 - 2013 A1 - Magiorkinis, E A1 - Paraskevis, D A1 - Pavlopoulou, I D A1 - Kantzanou, M A1 - Haida, C A1 - Hatzakis, A A1 - Boletis, I N KW - *Hepatitis B Surface Antigens/bl [Blood] KW - *Hepatitis B/vi [Virology] KW - *Kidney Transplantation/ae [Adverse Effects] KW - *Liver Failure, Acute/vi [Virology] KW - *Mutation KW - *Tissue Donors KW - Fatal Outcome KW - Hepatitis B Surface Antigens/im [Immunology] KW - Hepatitis B virus/ge [Genetics] KW - Hepatitis B/di [Diagnosis] KW - Hepatitis B/im [Immunology] KW - Hepatitis B/tm [Transmission] KW - Humans KW - Liver Failure, Acute/di [Diagnosis] KW - Liver Failure, Acute/im [Immunology] KW - Male KW - Middle Aged KW - Sequence Analysis, DNA AB - PURPOSE: The purpose of this study was to present a fatal case of fulminant hepatitis B (FHB) that developed in a renal transplant recipient, immunized against hepatitis B, 1 year post transplantation., METHODS: Polymerase chain reaction amplification and full genome sequencing were performed to investigate whether specific mutations were associated with hepatitis B virus (HBV) transmission and FHB., RESULTS: Molecular analysis revealed multiple mutations in various open reading frames of HBV, the most important being the G145R escape mutation and a frameshift mutation-insertion (1838insA) within the pre-C/C reading frame., CONCLUSIONS: Our results highlight the possibility of developing FHB, despite previous immunization against HBV or administration of hyperimmune gammaglobulin, because of the selection of escape virus mutants. The current literature and guidelines regarding renal transplantation from hepatitis B surface antigen (HBsAg)-positive to HBsAg-negative patients were also reviewed.Copyright © 2013 John Wiley & Sons A/S. M1 - d1d, 100883688 CY - Denmark VL - 15 SN - 1399-3062 CP - 4 L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=medl&NEWS=N&AN=23773581 ID - 4513 ER -