Hematopoietic stem cell transplantation from non-replicative hepatitis B virus carriers is safe

J Hepatol. 1999 Aug;31(2):202-9. doi: 10.1016/s0168-8278(99)80214-1.

Abstract

Background/aims: Hepatitis B virus can cause serious problems in individuals undergoing organ transplantation. The aim of this study was to evaluate the hepatic events among HBs-Ag positive recipients and HBs-Ag negative recipients who received products from hepatitis B virus carriers.

Methods: A total of 151 patients received an allogeneic hematopoietic stem cell transplantation at the Department of Hematology-Oncology, University of Ankara, between June 1989 and June 1998. Among these, eight HBs-Ag positive and four HBs-Ag negative recipients received a product from a hepatitis B virus positive donor. The median follow-up period for these 12 patients was 13.2 months.

Results: Three of the eight HBs-Ag positive recipients died (one from hepatic failure); of the remainder, two are HBs-Ag negative, two HBs-Ag positive with normal liver injury tests and one HBs-Ag positive with elevated ALT levels. Of the four HBs-Ag negative recipients who received stem cells from a hepatitis B positive donor, two died; none of the patients in this group became HBs-Ag positive after transplantation.

Conclusion: Hepatitis B virus infection is a common problem in patients being considered for allogeneic hematopoetic stem cell transplantation, especially in areas where hepatitis B virus infection is endemic. We believe that the presence of HBs-Ag positivity is not an absolute contraindication for allogeneic hematopoetic stem cell transplantation unless the hepatitis B virus is in a replication phase.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Carrier State / immunology*
  • Carrier State / virology
  • Contraindications
  • Fatal Outcome
  • Hematopoietic Stem Cell Transplantation*
  • Hepatitis B / immunology
  • Hepatitis B / prevention & control*
  • Hepatitis B / transmission
  • Hepatitis B Surface Antigens / blood*
  • Hepatitis B virus / pathogenicity*
  • Humans
  • Immunity, Innate
  • Immunosuppression Therapy
  • Immunotherapy, Adoptive
  • Male
  • Middle Aged
  • Virus Replication

Substances

  • Hepatitis B Surface Antigens