Hepatitis B positive donors

[Jie]

if you are offered a hepatitis B positive kidney, would you take it? I heard that there are 1% chance that a hepatitis B negative kidney transplant patient can develop hepatitis B from a hepatitis B positive kidney. Is this risk small enough to take, considering all other risks in the dialysis?


The risk may be higher for hepatitis B positive patients who go through a kidney transplant. More I thought about the hepatitis B issue, more I am confused.

[Chris]

My first though is no since I already have enough medical problems, but maybe if I have been on the list for several years and health was getting worse due to dialysis, I might change my mind.

[texasstyle]

Have you heard that someone would actually do a transplant from someone with Hep B? Is this a friend or family member offering? Hep B is a virus just as A & C are. With A, it'll make you sick often but your body is able to clear the virus on it's own. In B about 85% of people are able to clear the virus own thier own. With C, only about 15% are. If you  can't clear it you end up having chronic liver disease as it effects the liver even though you're speaking of a kidney transplant. Over time (mostly with C), your liver becomes infalmmed then the good tissue is replced with fibrosis or scar tissue leading to cirrhosis and liver failure. Everyone reacts to the virus differently as some people can go through life with minimal liver damage but would you want to risk not being one of those? A person who is positive for any form of Hepattis cannot even donate blood. Again, Hepatitis B is a virus found in the bloodstream that effects the liver.Having then the virus in you can give you other symptoms over time. I would educate yourself as much as possible onthis matter of thinking about getting a donated liver with the infection. I'm suprised it would even be done.

[Jie]

Basically this is a tradeoff of risks. Dialysis patients have high risks for other big problems, like heart and bone. The 1% risk is relatively small, compared to 20% of annual mortality rate of dialysis patients and 6%-7% of annual mortality rates for the "healthy" dialysis patients who are on the waiting list in the U.S. 

[texasstyle]

I don't really know what I would do in that kind of situation. I'm not thinking very well today because it wasn't coming to mind the mortatilty rate of a dialysis patient and the fact there is a chance to get off that machine.  Interesting topic though.

[Zach]

if you are offered a hepatitis B positive kidney, would you take it? I heard that there are 1% chance that a hepatitis B negative kidney transplant patient can develop hepatitis B from a hepatitis B positive kidney. Is this risk small enough to take, considering all other risks in the dialysis?


The risk may be higher for hepatitis B positive patients who go through a kidney transplant. More I thought about the hepatitis B issue, more I am confused.

I think your 1% risk might be a bit low.  Can you give us a link to that statistic?

At least with Hep B, there is a vaccine against the virus that all dialysis patients should receive.

Here is a little more information on the subject.
http://www.bioportfolio.com/resources/pmarticle/20353/Review-Of-The-Use-Of-Hepatitis-B-Core-Antibody-positive-Kidney-Donors.html

[Jie]

Thanks Zach. This is a good review. I make me feel better to know that "If the donor is anti-HBc (+) and hepatitis B DNA negative, the risk of transmission is negligible". This 1% risk is for this scenario. If the anti-HBs and DNA are positive, then the risk is much higher, and some centers would not use such kidneys at all. 

[texasstyle]

OK ,sohere is my opinon and I am going to be honest. Hepatitis itself means "inflammation of the Liver". An alochoholic per say can go through bouts of this inflammtion. Anything "Hepatic" of course, means of the Liver. Hepatits B even though the chances of not clearing the irues or much slimmer than Hepattis C, is STILL A VIRUS. It is in your bloodstream and there is lots of blood in your liver. to bring that into your body would just be crazy in my opion ans still, I cn't see anyone doing tis procedure. Am I wrong? It's like adding fuel t the fire. I treated for hep C myself and was scucessful but it was hell. My liover already had damage. There is a vaccine but with any vaccine you must get it before the virus enters you.

[paris]

Not sure if I would take the risk.  You go through so much to get the new kidney, that I wouldn't want something that could then damage the liver.  I agree with Texasstyle.