Session Name: Kidney Deceased Donor Selection
Session Date & Time: None. Available on demand.
*Purpose: There is an increasing demand for kidney donations as roughly 4000 people die on the waitlist each year while the number of kidneys being discarded has continued to increase1,2. Despite use of Hep C positive kidneys, thousands of kidneys are discarded annually3. Nucleic Acid Test (NAT) is a rapid test used to detect presence of a virus prior to serologic conversion and the false positive rate remains unknown4. We present nine patients with hepatitis B surface antibodies of >100 mIU/mL that received renal transplants from NAT positive donors without evidence of seroconversion.
*Methods: During annual transplant evaluation, HBsAb quantitative levels were obtained. Patients with HBsAb >100mIU/mL were offered to accept Hep B antigen negative, Hep B NAT positive kidneys with informed consent. From July 2019 – July 2020, 9 patients were transplanted with Hep B NAT positive kidneys. Hep B NAT and Hep B surface antigen were checked at 4 weeks, 12 weeks and 12 months postoperatively. Hep B surface antibody and Hep B core antibodies were performed 6 months post-transplant.
*Results: None of our patients experienced seroconversion or active viremia to date. Three patients will complete one year surveillance on June 2021 (Table 1). Due to small sample size, no statistical analyses were performed. Evaluation of our cohorts wait time compared to matching blood types is ongoing.
|Patient ID||Gender||Age (years)||KDPI %||HBsAb quantitative value (mIU/mL)||12 week/ 1 year Hep B NAT||Creatinine 1 year post transplant (mg/dL)|
*Conclusions: We have successfully transplanted nine NAT positive kidneys into patients with immunity to Hep B without inducing active hepatitis. Our results support the use of Hep B NAT positive donors into recipients with high levels of immunity. This may assist in decreasing the number of discarded kidneys but further research is needed.
To cite this abstract in AMA style:Stephenson E, Nangunuri B, McCune T. Use of Hepatitis B N.A.T. Positive Kidneys in Hepatitis B Immune Recipients [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/use-of-hepatitis-b-n-a-t-positive-kidneys-in-hepatitis-b-immune-recipients/. Accessed September 22, 2021.
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