DE-NOVO AND APPARENT DE-NOVO HEPATITIS-B VIRUS-INFECTION AFTER LIVER-TRANSPLANTATION

Bnckground/Aims: The aim of this study was to clarify the aetiology of apparent ne novo HBV infection after liver transplantation. Methods: Twenty out of 570 HBsAg negative patients (3.5%) became HBsAg positive after transplantation and were studied, Donor and recipient sera were retrospectively tested for HBsAg, anti-HBs, anti-HBc, and HBV DNA by PCR, Donor and recipient livers were tested for HBV DNA by PCR on para ffin-embedded tissue. Results: Group 1: HBV infection of donor origin (eight patients): one donor serum was HBsAg positive, three were serum HBV DNA positive, four were liver HBV DNA positive, Group 2: reactiva tion of latent HBV infection (eight patients) with detection of HBV DN A in pretransplant serum (seven patients) or in native liver (one pati ent): three were anti-HBs positive, two anti-HBe positive, and three w ith fulminant hepatitis had no serological HBV markers, Group 3: undet ermined origin (four patients) defined by absence of HBV DNA in pretra nsplant donor and/or recipient sera and liver; however, acquired infec tion was suspected from two anti-HBs and anti-HBc positive donors, Two patients became HBsAg negative, and five HBV DNA negative, One died f rom HBV-cirrhosis and two were retransplanted, In the others, the last histology showed cirrhosis (three), chronic hepatitis (nine), acute h epatitis (one), and non-specific change (four patients). Conclusions: The prevalence of ne novo HBV infection in liver transplant patients w as 3.5%; the aetiology was determined in 16/20 patients: from the dono r in eight, and from the recipient in eight, One should be cautious wh en donors or recipients are anti-HBc or both anti-HBs and anti-HBc pos itive.