Introduction: HBV can be transmitted from organ donor to recipient and is one of the viruses targeted by US Public Health Service increased risk (IR) guidelines. The frequency of donor derived HBV events is not known.

Methods: The multidisciplinary DTAC evaluates potential donor derived transmission events. 103 cases of potential HBV transmission were evaluated by DTAC between 2009-2016.

Results: There were 11 HBV infections that were adjudicated as probable or proven donor-derived transmissions. 9/11 were transmissions from HBV core antibody (Ab) + donors; 10/18 recipients were infected; 3 were liver recipients without antiviral prophylaxis (ppx); 2 were liver recipients after completion of 2 years of antiviral ppx; 2 were liver recipients on lamivudine ppx, 3 were kidney recipients with HBV infection ranging from active viremia to seroconversion without viremia. 2 donors with negative serology (NAT not done) transmitted HBV unexpectedly resulting in 4 transmissions out of 8 recipients (50%). Cases were diagnosed at a median of 535 (99-893) days post-transplant with the 2 seronegative donor-derived transmissions diagnosed at an average of 313 days post-transplant. In 3 cases, testing of recipients around 3 months post-transplant was negative.

Conclusions: Unexpected donor-derived transmission of HBV is a rare event and can be detected late post-transplant. The majority of these events could be prevented with anti-viral prophylaxis when using liver donors with core Ab, even in the presence of negative donor NAT.

CITATION INFORMATION: Theodoropoulos N., Tlusty S., Vece G., Berry G., Bucio J., Danziger-Isakov L., Florescu D., Goldberg D., Ho C., La Hoz R., Lilly K., Malinis M., Mehta A., Nalesnik M., Sawyer R., Strasfeld L., Wood R., Michaels M., Wolfe C. Donor-Derived Hepatitis B Virus (HBV) Infection: Analysis of the OPTN/UNOS Ad Hoc Disease Transmission Advisory Committee (DTAC) Am J Transplant. 2017;17 (suppl 3).

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