Publication: Kidney transplant from donors with hepatitis B: A challenging treatment option
Issued Date
2021-01-01
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ISSN
19485182
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2-s2.0-85113756211
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Mahidol University
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SCOPUS
Bibliographic Citation
World Journal of Hepatology. Vol.13, No.8 (2021), 853-867
Suggested Citation
Praopilad Srisuwarn, Vasant Sumethkul Kidney transplant from donors with hepatitis B: A challenging treatment option. World Journal of Hepatology. Vol.13, No.8 (2021), 853-867. doi:10.4254/wjh.v13.i8.853 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78636
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Title
Kidney transplant from donors with hepatitis B: A challenging treatment option
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Abstract
Utilizing kidneys from donors with hepatitis B is one way to alleviate the current organ shortage situation. However, the risk of hepatitis B virus (HBV) transmission remains a challenge that undermines the chance of organs being used. This is particularly true with hepatitis B surface antigen (HBsAg) positive donors despite the comparable long-term outcomes when compared with standard donors. To reduce the risk of HBV transmission, a comprehensive approach is needed. This includes assessment of donor risk, optimal allocation to the proper recipient, appropriate immunosuppressive regimen, optimizing the prophylactic therapy, and post-transplant monitoring. This review provides an overview of current evidence of kidney transplants from donors with HBsAg positivity and outlines the challenge of this treatment. The topics include donor risk assessment by adopting the nucleic acid test coupled with HBV DNA as the HBV screening, optimal recipient selection, importance of hepatitis B immunity, role of nucleos(t)ide analogues, and hepatitis B immunoglobulin. A summary of reported long-term outcomes after kidney transplantation and proposed criteria to utilize kidneys from this group of donors was also defined and discussed.