Safety of anti-hepatitis B core antibody-positive donors for living-donor liver transplantation

Serologic evidence of resolved hepatitis B virus (HBV) infection (HBV surface antigen negative, anti-HBV core antibody [HBc] positive) in a liver donor can be regarded as an occult infection with episomal HBV in the liver. The purpose of this study was to evaluate the safety of anti-HBc-positive living donors. Between March 2001 and January 2002, 127 donors underwent hepatectomy for living-donor liver transplantation at Asan Medical Center. They were classified as members of an anti-HBc-positive group (n=50) or an anti-HBc-negative group (n=77). The two groups were subdivided into right lobectomy (n=86) and left lobectomy (n=34) groups to compare operative risk. Perioperative clinical profiles were compared by anti-HBc status and extent of donor hepatectomy. There were no statistical differences of preoperative liver function and liver steatosis between the anti-HBc-positive and anti-HBc-negative groups. Operation time and blood loss did not show any differences between the hepatectomy-matched anti-HBc-positive and anti-HBc-negative groups. Postoperative recovery of liver function, incidence of complication, and regeneration rate of the remnant liver after right lobectomy also did not show significant differences. The anti-HBc-positive group did not exhibit any adverse preoperative, intraoperative, or postoperative outcomes compared with the anti-HBc-negative group. This indicates that anti-HBc-positive donors can be assessed to have the same degree of risk for donor operation as anti-HBc-negative donors.