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Abstract Details
HBV-positive and HIV-positive organs in transplantation: a clinical guide for the hepatologist
J Hepatol. 2022 Apr 7;S0168-8278(22)00175-1. doi: 10.1016/j.jhep.2022.03.007.Online ahead of print.
1Department of Surgery, Oncology and Gastroenterology, Gastroenterology and Multivisceral Transplant Unit, University Hospital Padua.
2Division of Hepatology, San Giuseppe Hospital, MultiMedica IRCCS, Milan, Italy.
3Department of Surgery, University of California at San Francisco, San Francisco, California, USA.
4Unit of Gastroenterology, Borgo Trento University Hospital of Verona, Verona, Italy.
5Department of Biomedical Sciences, Humanitas University, Milan, Italy; Division of Internal Medicine and Hepatology, Department of Gastroenterology, Humanitas Research Hospital IRCCS, Milan, Italy.
6Department of Surgery, Oncology and Gastroenterology, Gastroenterology and Multivisceral Transplant Unit, University Hospital Padua. Electronic address: burra@unipd.it.
Abstract
Organ transplantation is a life-saving treatment for patients with end-stage organ disease, a severe condition associated with a high risk of waitlist mortality. It is primarily limited by a shortage of available organs. Maximizing available donors can increase access to transplantation. Transplantation from donors positive for hepatitis B and HIV has increased in many countries. However, antiviral therapies need to be readily available after the transplantation for the recipients to prevent possible reactivation of the virus following the administration of immunosuppressive therapies. Furthermore, the intentional transmission of a virus has practical, ethical, and health implications. In this review, we summarized the current research, focusing on grafts from donors positive for antibodies against the HBV core antigen (anti-HBc), Hepatitis B surface antigen (HBsAg), and HIV, to help hepatologists and physicians interested in transplantation in selecting the best antiviral and/or prophylactic regimen to be administered after transplantation.