RISK OF INAPPROPRIATE EXCLUSION OF ORGAN DONORS BY INTRODUCTION OF HEPATITIS-B CORE ANTIBODY TESTING

Background. Hepatitis B virus infection originating from hepatitis B s urface antigen-negative, hepatitis B core antibody (anti-HBc)-positive organ donors has been documented, and anti-HBc-positive donors have b een excluded as liver donors. We assessed the prevalence of anti-HBc i n UK organ donors and followed up recipients of organs from anti-HBc-p ositive donors for serological evidence of posttransplantation hepatit is B virus infection. Methods. Serum samples from 400 hepatitis B surf ace antigen-negative organ donors were tested for anti-HBc. Results. O nly five (1.25%) of 20 sera in which anti-HBc was initially detected w ere confirmed as anti-HBc positive on further testing. Posttransplanta tion serum samples from four recipients of confirmed anti-HBc-positive organs showed no evidence of de novo hepatitis B infection. Conclusio ns. The poor specificity of some anti-HBc immunoassays was confirmed a nd suggests that donor exclusion on the basis of a single anti-HBc-pos itive result may result in the inappropriate loss of organs.