Liver Transplantation Management from Anti HBc Positive Donors to HBV Negative Recipients in Liver Transplantation

Anti HBc + people are in the marginal donor group. It is considered as a donor source, especially in places where Hepatitis B is endemic. In endemic areas, 21.4% of donors are HBcAb positive. In regions where HBV is not endemic, it is 4.75%-7%. Anti-HBc is a 'non-neutralizing' antibody that does not provide immune protection. In other words, it is 'serological scar', that is the evidence of previous exposure to HBV). De novo hepatitis may develop in liver transplants from anti-HBc positive donors. The most important factors for de novo hepatitis are the presence or absence of anti-HBc and anti-HBs positivity. If both antibodies are positive, the risk of denovo hepatitis is least and if both antibodies are negative, it is highest. High genetic barrier antivirals alone are recommended for the treatment and prophylaxis of developing de novo hepatitis. Hepatitis B immune globulin has no place in de novo treatment and prevention.