Maximize Donor Cornea Use in a Hepatitis B Endemic Area via Serology Matching.

Autor:	Chu HS; Department of Ophthalmology, National Taiwan University Hospital, Taipei City, Taiwan.; National Eye Bank of Taiwan, Ministry of Health and Welfare, Taipei City, Taiwan.; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei City, Taiwan., Killeen OJ; Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI., Hsieh YT; Department of Ophthalmology, National Taiwan University Hospital, Taipei City, Taiwan., Su TH; Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan.; Hepatitis Research Center, National Taiwan University Hospital, Taipei City, Taiwan., Soong HK; Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI., Shih CL; Ministry of Health and Welfare, Taipei City, Taiwan., Hu FR; Department of Ophthalmology, National Taiwan University Hospital, Taipei City, Taiwan.; National Eye Bank of Taiwan, Ministry of Health and Welfare, Taipei City, Taiwan.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2023 Jun 01; Vol. 107 (6), pp. 1341-1347. Date of Electronic Publication: 2022 Dec 06.
DOI:	10.1097/TP.0000000000004460
Abstrakt:	Background: This study aims to investigate the rationality of the allocation guidelines in a hepatitis B endemic area that uses corneas from hepatitis B donors. Methods: Under Taiwan's current guidelines, corneas donated from hepatitis B surface antigen (HBsAg)(+) donors can be allocated to HBsAg(+) or hepatitis B surface antibody recipients. From January 1, 2015, to December 31, 2019, corneas donated to National Taiwan University Hospital were divided into HBsAg(+), HBsAg(-)/hepatitis B core antibody (anti-HBc)(+), and HBsAg(-)/anti-HBc(-) groups. Hepatitis B virus (HBV) DNA extracted from corneoscleral rims was quantified by polymerase chain reaction and correlated with donor serum HBsAg, anti-HBc, and HBV DNA. Recipients of HBV DNA(+) grafts were called back for serology and serum HBV DNA tests. Results: The corneoscleral HBV DNA of 170 corneas (113 donors) was quantified, of which 45 corneas were from 28 HBsAg(+) donors, 87 were from 57 HBsAg(-)/anti-HBc(+) donors, and 38 were from 28 HBsAg(-)/anti-HBc(-) donors, and HBV DNA was detected in 80.0%, 9.2%, and 0% of the corneoscleral rims in each group. Donor anti-HBc(+) provided the highest sensitivity (1.00) and negative predictive value (1.00) for corneoscleral HBV DNA. Twenty-eight of 40 recipients (70%) using HBV DNA(+) grafts were called back, and none developed hepatitis in follow-up periods ranging from 6 to 55.5 mo. Conclusions: Donor anti-HBc should be tested routinely with HBsAg. Allocating corneas from HBsAg(+) or anti-HBc(+) donors to HBsAg(+) or hepatitis B surface antibody recipients maximizes cornea usage from hepatitis B donors without compromising transplant safety in a hepatitis B endemic setting. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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