Efficacy and safety of using HBIg from hepatits B virus core antibody-positive donors for prevention of de novo hepatitis B infection in patients with renal transplantation

PENG Sha-sha; LIN Jie; HUANGH an-fei; LIU Tao; ZENG Zhong; DUAN Jian

doi:10.3969/j.issn.1002-266X.2014.21.001

Abstract：Objective To investigate the safety and efficacy of using low dose of hepatitis B immunoglobulin (HBIg) from hepatitis B virus core antibody-positive donors for prevention of de novo hepatitis B infection after kidney transplantation (KT). Methods Sixty-nine patients who received KT without hepatitis B infection were retrospectively studied .All donors were hepati-tis B virus surface antigen (HBsAg) negative and HBcAb-IgM positive.We randomly divided them into the observation group (n=39) and the control group (n=30).All patients in the observation group were given low dose of HBIg injection before and af-ter transplantation.Patients in the control group were not treated with HBIg .The function of liver and kidney in the two groups was analyzed.The de novo HBV incidence after KT 12, 36 months were compared between the two groups.Results One case had acute rejection after operation in the observation group.During the follow-up of 3-36 months, 2 patients died of pulmonary infection after operation 8 and 12 months in the observation group, and 1 patients died of pulmonary infection 6 months after KT, 1 case died of acute hepatic failure 24 months after KT.The incidences of new onset hepatitis B 12 and 36 months after KT were 0 and 2.6%in the observation group, while those of the control group were 10.3%and 17.9%(all P<0.05 ).The differences were statistically significant in creatinine (Scr) and total bilirubin (TBiL) after 12,24 and 36 months of KT between the two groups as well as the abnormal rate of liver function in 24 months (all P<0.05).Conclusion When KT patients receive kid-neys from HBcAb-IgM positive donors, we preventively apply the HBIg to produce passive immunity, which can effectively re-duce the incidence of hepatitis B, improve the liver and renal function as well as prolong the survival time after operation .