• Aaron M Delman, Kevin M Turner, Kamran Safdar, Nadeem Anwar, Latifa S Silski, Tiffany C Lee, Keith Luckett, Madison C Cuffy, Ralph C Quillin, Michael Schoech, Tiffany E Kaiser, Amit Govil, Khurram Bari, and Shimul A Shah.
• Cincinnati Research in Outcomes and Safety in Surgery (CROSS) Research Group, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH.
• Ann. Surg. 2021 Oct 1; 274 (4): 556-564.

ObjectivesThe aim of this study was to assess the 1-year safety and effectiveness of HBV Nucleic Acid Test positive (HBV NAT+) allografts in seronegative kidney transplant (KT) and liver transplant (LT) recipients.Summary Background DataDespite an ongoing organ shortage, the utilization of HBV NAT+ allografts into seronegative recipients has not been investigated.MethodsFrom January 2017 to October 2020, a prospective cohort study was conducted among consecutive KT and LT recipients at a single institution. Primary endpoints were post-transplant HBV viremia, graft and patient survival.ResultsWith median follow-up of 1-year, there were no HBV-related complications in the 89 HBV NAT+ recipients. Only 9 of 56 KTs (16.1%) and 9 of 33 LTs (27.3%) experienced post-transplant HBV viremia at a median of 185 (KT) and 269 (LT) days postoperatively. Overall, viremic episodes resolved to undetected HBV DNA after a median of 80 days of entecavir therapy in 16 of 18 recipients. Presently, 100% of KT recipients and 93.9% of LT recipients are HBV NAT- with median follow-up of 13 months, whereas 0 KT and 8 LT (24.2%) recipients are HBV surface antigen positive indicating chronic infection. KT and LT patient and allograft survival were not different between HBV NAT+ and HBV NAT- recipients (P > 0.05), whereas HBV NAT+ KT recipients had decreased waitlist time and pretransplant duration on dialysis (P < 0.01).ConclusionsThis is the largest series describing the transplantation of HBV NAT+ kidney and liver allografts into HBV seronegative recipients without chronic HBV viremia or decreased 1-year patient and graft survival. Increasing the utilization of HBV NAT+ organs in nonviremic recipients can play a role in decreasing the national organ shortage.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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