Hepatitis B Seropositive Donor Organs Can Be Transplanted Safely, Effectively

Pratt CG, Noriega N, Delman AM, et al. Friend or Foe? Safety and Efficacy of Hepatitis B Viremic Solid Organ Allograft into Seronegative Patients. J Am Coll Surg. 2025; in press.

The shortage of donor organs continues to limit the use of solid organ transplantation for chronic liver and kidney failure. Less than 1/3 of eligible patients are successfully transplanted. Use of organs from hepatitis B (HBV) seropositive donors has been successfully used to increase donor organ availability in several transplant centers because of increased effectiveness of treatments for hepatitis B viremia.

This study reported long-term (median 36 months) outcomes in patients (n = 180) receiving liver or kidney transplants from seropositive donors compared with patients receiving organs from seronegative patients. Outcomes of interest were patient and graft survival, rates of viremia, and rates of positive detectable HBV DNA.

The data showed that rates of patient and graft survival were similar in both groups. Viremia occurred in 14.8% of seropositive patients and 3.5% of seronegative patients. HBV DNA was undetectable in 100% of seronegative patients and 96.9% of seropositive patients.

The authors concluded that viremia can be successfully detected and treated with long-term surveillance making transplantation with seropositive donor organs safe and effective.