ABO-Incompatible Living Donor Liver Transplantation from Hepatitis B Core Antibody Positive Donor to Hepatitis C Liver Cirrhosis Recipient: A Case Report

Herein, we describe an extremely rare experience of a patient with liver cirrhosis from hepatitis C virus (LC-HCV) who underwent an ABO-incompatible living donor liver transplantation (ABO-I-LDLT) using a hepatitis B core antibody (HBc-Ab) positive donor’s liver graft. A 47-year-old Japanese woman w...

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Main Authors: Akira Umemura, Hiroyuki Nitta, Akira Sasaki, Takeshi Takahara, Yasushi Hasegawa, Go Wakabayashi
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Transplantation
Online Access:http://dx.doi.org/10.1155/2014/507621
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author Akira Umemura
Hiroyuki Nitta
Akira Sasaki
Takeshi Takahara
Yasushi Hasegawa
Go Wakabayashi
author_facet Akira Umemura
Hiroyuki Nitta
Akira Sasaki
Takeshi Takahara
Yasushi Hasegawa
Go Wakabayashi
author_sort Akira Umemura
collection DOAJ
description Herein, we describe an extremely rare experience of a patient with liver cirrhosis from hepatitis C virus (LC-HCV) who underwent an ABO-incompatible living donor liver transplantation (ABO-I-LDLT) using a hepatitis B core antibody (HBc-Ab) positive donor’s liver graft. A 47-year-old Japanese woman with end stage LC-HCV, as a recipient, was preoperatively administered rituximab, mycophenolate mofetil, and steroids without plasma exchange. A routine ABO-I-LDLT procedure was applied using her daughter’s HBc-Ab positive liver graft. Prophylaxis of the hepatitis B virus (HBV) infection using hepatitis B immunoglobulin (HBIG) and entecavir had been properly administered. Three months after the ABO-I-LDLT, HCV hepatitis relapsed. To date, this patient has been under antiviral therapy and prophylaxis of HBV infection using HBIG, while entecavir has been continued. The cognitions and techniques with regard to ABO-I-LDLT, prophylaxis of HBV cross infection, various patterns of immunosuppression, and antiviral therapy for HCV relapse are indispensable in managing a transplant recipient. According to the prophylaxis of HBV cross infection under ABO-I-LDLT, it may be very important to keep the HBs-Ab titer higher than usual for HBV naïve recipients, because severe systemic immunosuppression can cause de novo hepatitis.
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spelling doaj-art-2631bbf45d3e4038aa196e9e943f20632025-08-20T02:04:26ZengWileyCase Reports in Transplantation2090-69432090-69512014-01-01201410.1155/2014/507621507621ABO-Incompatible Living Donor Liver Transplantation from Hepatitis B Core Antibody Positive Donor to Hepatitis C Liver Cirrhosis Recipient: A Case ReportAkira Umemura0Hiroyuki Nitta1Akira Sasaki2Takeshi Takahara3Yasushi Hasegawa4Go Wakabayashi5Department of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDepartment of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDepartment of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDepartment of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDepartment of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanDepartment of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka 020-8505, JapanHerein, we describe an extremely rare experience of a patient with liver cirrhosis from hepatitis C virus (LC-HCV) who underwent an ABO-incompatible living donor liver transplantation (ABO-I-LDLT) using a hepatitis B core antibody (HBc-Ab) positive donor’s liver graft. A 47-year-old Japanese woman with end stage LC-HCV, as a recipient, was preoperatively administered rituximab, mycophenolate mofetil, and steroids without plasma exchange. A routine ABO-I-LDLT procedure was applied using her daughter’s HBc-Ab positive liver graft. Prophylaxis of the hepatitis B virus (HBV) infection using hepatitis B immunoglobulin (HBIG) and entecavir had been properly administered. Three months after the ABO-I-LDLT, HCV hepatitis relapsed. To date, this patient has been under antiviral therapy and prophylaxis of HBV infection using HBIG, while entecavir has been continued. The cognitions and techniques with regard to ABO-I-LDLT, prophylaxis of HBV cross infection, various patterns of immunosuppression, and antiviral therapy for HCV relapse are indispensable in managing a transplant recipient. According to the prophylaxis of HBV cross infection under ABO-I-LDLT, it may be very important to keep the HBs-Ab titer higher than usual for HBV naïve recipients, because severe systemic immunosuppression can cause de novo hepatitis.http://dx.doi.org/10.1155/2014/507621
spellingShingle Akira Umemura
Hiroyuki Nitta
Akira Sasaki
Takeshi Takahara
Yasushi Hasegawa
Go Wakabayashi
ABO-Incompatible Living Donor Liver Transplantation from Hepatitis B Core Antibody Positive Donor to Hepatitis C Liver Cirrhosis Recipient: A Case Report
Case Reports in Transplantation
title ABO-Incompatible Living Donor Liver Transplantation from Hepatitis B Core Antibody Positive Donor to Hepatitis C Liver Cirrhosis Recipient: A Case Report
title_full ABO-Incompatible Living Donor Liver Transplantation from Hepatitis B Core Antibody Positive Donor to Hepatitis C Liver Cirrhosis Recipient: A Case Report
title_fullStr ABO-Incompatible Living Donor Liver Transplantation from Hepatitis B Core Antibody Positive Donor to Hepatitis C Liver Cirrhosis Recipient: A Case Report
title_full_unstemmed ABO-Incompatible Living Donor Liver Transplantation from Hepatitis B Core Antibody Positive Donor to Hepatitis C Liver Cirrhosis Recipient: A Case Report
title_short ABO-Incompatible Living Donor Liver Transplantation from Hepatitis B Core Antibody Positive Donor to Hepatitis C Liver Cirrhosis Recipient: A Case Report
title_sort abo incompatible living donor liver transplantation from hepatitis b core antibody positive donor to hepatitis c liver cirrhosis recipient a case report
url http://dx.doi.org/10.1155/2014/507621
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