© 2002 by Gut
COMMENTARY
Liver disease
Positive suggestions about the anti-HBc positive donor
Liver and Hepatobiliary Unit, Queen Elizabeth Hospital, Birmingham, UK
Correspondence to:
Correspondence to:
D Mutimer;
david.mutimer@university_b.wmids.nhs.uk
What to do with the anti-hepatitis B virus core antigen positive donor liver
The paper by Roque-Afonso et al in this issue of Gut1 describes the outcome of recipients following transplantation of livers from organ donors who have detectable antibody to the hepatitis B virus (HBV) core antigen (HBc) but undetectable serum hepatitis B surface antigen (anti-HBc positive, HBsAg negative) (see 95). Serum anti-HBc positivity simply confirms exposure to HBV. Its presence in the absence of serum HBsAg identifies the patient with resolved infection. Frequently, antibodies to HBsAg (anti-HBs) will be absent, fading in titre for many patients from the time of acute infection. Thus the patient with a past resolved HBV infection will be anti-HBc positive and HBsAg negative, and anti-HBs may or may not be present. Irrespective of the anti-HBs status of the donor, it is known that the use of anti-HBc positive (HBsAg negative) donor livers will transmit HBV to the recipient and will establish chronic infection
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