Researchers analyzed data from 20 previous studies involving 600 kidney transplant patients. These patients received kidneys from donors who had active hepatitis B virus (HBV) infections, while the recipients themselves did not have active HBV. Most donors were living, and most recipients had some protective antibodies against hepatitis B. About half of the recipients received antiviral medication to help prevent infection.
The analysis found that overall, about 4% of recipients developed a new hepatitis B infection after their transplant. Importantly, most of these infections were temporary and showed only low levels of the virus. However, the risk was much higher (16%) when all donors had detectable virus in their blood. The review also reported three deaths that were linked to hepatitis B transmission, all occurring in recipients who were not taking preventive antiviral drugs after their transplant.
This research combines information from existing studies, which means it shows patterns but cannot prove what causes specific outcomes. The findings suggest that with careful donor selection and preventive treatment, transplants from HBV-positive donors might be an option to expand the donor pool. However, the deaths highlight that skipping preventive medication carries serious risks. Patients should discuss these complex risks and benefits with their transplant team.
