THE SIGNIFICANCE OF COMPLETE SEROLOGICAL TESTING FOR HEPATITIS-B IN HEART-VALVE BANKING

Allograft heart valves obtained from donor hearts have been cryopreser ved in the Heart Valve Bank in Rotterdam for transplantation purposes. In contrast to hepatitis B screening of organ donors, which consists of only a rapid HBV surface antigen (HBsAg) assay, tissue donors can b e screened more completely for hepatitis B virus (HBV) by HBsAg and an tibodies against HBV core antigen (anti-HBc) tests, and when necessary , anti-HBs and HBV-DNA tests. The value of this complete HBV screening was investigated by evaluation of the HBV screening results of 676 do nor sera. HBsAg was positive in 1 serum. Anti-HBc was positive in 63 s era, of which 52 also had positive antibodies against HBV surface anti gen (anti-HBs) tests (no risk of transmission) and 10 had negative ant i-HBs tests. In 3 cases with a negative anti-HBs test the HBV-DNA test was positive (risk of transmission). In 3 cases not enough serum was available to perform all tests, resulting in a total of 7 rejected don ors. Single HBsAg testing would have resulted in the rejection of only 1 donor. In the presented group of selected donors, approximately 0.5 % of the HBsAg-negative donors were lower-level chronic carriers of he patitis B. Complete HBV screening decreases the risk of transmission o f hepatitis B in allograft heart valve transplantation.