Transplantation of Hepatitis B Surface Antigen Positive or Viremic Kidneys: A Systematic Review and Meta-Analysis.

In 30 seconds

This systematic review and meta-analysis assessed outcomes after transplantation of hepatitis B surface antigen-positive or viremic kidneys into non-viremic kidney transplant recipients. Eleven studies were reviewed, with six comparative studies included in the meta-analysis: 638 recipients of HBV-positive kidneys and 2,800 recipients of HBV-negative, non-viremic kidneys. Allograft survival was comparable at 1, 3, and 5 years; the respective risk ratios were 1 [0.98-1.01], 1.01 [0.98-1.04], and 1.00 [0.91-1.09]. Patient survival was also comparable, and reported HBV transmission was 4.94%.

Key findings

• Allograft survival risk ratios at 1, 3, and 5 years were 1 [0.98-1.01], 1.01 [0.98-1.04], and 1.00 [0.91-1.09], respectively.
• Patient survival was comparable between recipients of HBV-positive and HBV-negative kidneys.
• HBV transmission was reported in 4.94% of recipients, with lower rates especially when prophylaxis was used and recipients were immune before transplantation.

Why it matters

The findings suggest that kidneys from HBV-infected donors may offer an additional source of organs without an observed survival disadvantage in the reviewed evidence. The low reported transmission rate, particularly with recipient immunity and prophylaxis, is relevant to assessing donor-organ use, while the evidence remains based on a limited number of comparative studies.

What to keep in mind

Only six of the eleven included studies contributed to the meta-analysis, and the abstract does not report randomized comparisons.