Hematopoietic stem cell transplantation from non-replicative hepatitis B virus carriers is safe

Background/Aims: Hepatitis B virus can cause serious problems in individual s undergoing organ transplantation. The aim of this study was to evaluate t he hepatic events among HBs-Ag positive recipients and HBs-Ag negative reci pients who received products from hepatitis B virus carriers. Methods: A total of 151 patients received an allogeneic hematopoietic stem cell transplantation at the Department of Hematology-Oncology, University o f Ankara, between June 1989 and June 1998, Among these, eight HBs-Ag positi ve and four HBs-Ag negative recipients received a product from a hepatitis B virus positive donor. The median follow-up period for these 12 patients w as 13.2 months. Results: Three of the eight HBs-Ag positive recipients died (one from hepat ic failure); of the remainder, two are HBs-Ag negative, two HBs-Ag positive with normal liver injury tests and one HBs-Ag positive with elevated ALT l evels, Of the four HBS-Ag negative recipients who received stem cells from a hepatitis B positive donor, two died; none of the patients in this group became HBs-Ag positive after transplantation. Conclusion: Hepatitis B virus infection is a common problem in patients bei ng considered for allogeneic hematopoetic stem cell transplantation, especi ally in areas where hepatitis B virus infection is endemic, We believe that the presence of HBs-Ag positivity is not an absolute contraindication for allogeneic hematopoetic stem cell transplantation unless, the hepatitis B v irus is in a replication phase.