Hepatitis B virus status of organ donors in Argentina
Maria Anders1, Ariel Antik3, Manuel Mendizabal2, Federico Piñero2, Daniela Hansen Krogh3, Federico Orozco1, Viviana Tagliafichi3, Julia Brutti1, Marcelo Silva2, Gabriela Hidalgo4, Liliana Bisignano2.
1Unidad de Trasplante, Hospital Aleman, Buenos Aires, Argentina; 2Unidad de Hígado y Trasplante Hepático,, Hospital Universitario Austral, PIlar, Argentina; 3Dirección Científico Técnico, Instituto Unico Coordinador de Ablación e Implante, Buenos Aires, Argentina; 4Dirección Médica, Instituto Unico Coordinador de Ablación e Implante , Buenos Aires, Argentina
Background & Aims: Argentina is considered an area of a low prevalence of hepatitis B virus (HBV). However, the real prevalence of the disease is unknown. We aimed to study the prevalence of HBV in potential cadaveric donors.
Methods: We performed a cross-sectional study to analyze data from the National Procurement of Transplantation (INCUCAI) in Argentina from 2006 to 2020. We included data from all donors, including tissue only, effective donors (those for whom transplantation was effectively done), and non-effective donors. HBV serologic tests included hepatitis B virus antigen (HBsAg), core antigen-antibody (HBcIgG), anti-HBs. These tests were performed on all donors during the procurement process. HBV status was defined as 1) active HBV: donors with positive HBsAg; 2) Past HBV infection or false positive: isolated positive HBcIgG; 3) Cured infection anti-HBs+/HBcIgG+.
Results: Overall, 16140 deceased donors were denounced. Of these, 8627 (53.5%) were organ donors (7802 [90.4%] were effective) and 7513 (46.5%) were tissue donors. Demographic characteristics were age 42 ± 18 years; male/female ratio was 1.59/1. Overall, the prevalence of HBsAg was 0.37% (n=60) and of isolated HBcIgG+ was 3.6% (n=575). Among organ donors only, 328 (3.8%) presented isolated HBcIgG-positive serology. Of these, 252 (77%) were effective organ donors. Solid-organ transplants performed using isolated HBcIgG+ donors were 220 kidneys, 124 livers, and 27 intrathoracic organs. There was not significant 5-year graft and patient survival difference between HBcIgG+ receptor (kidney transplant 65% and 81%, and for liver 65% and 83% respectively) and general population (kidney transplant 67% (p0.58) and 92% (p0.77), and for liver 64% (p0.73) and 80% (p 0.83), respectively). Anti-HBs data were available in only 4455 donors of which 19% (N=847) were anti-HBs+. In those patients with positive anti-HBs, HBcIgG was positive in 8.3% (n=369). reflecting past HBV infection. Of the remaining 4086 AntiS available, only 11.7% were positive, that is, they were effectively vaccinated. The Patagonia region presented the highest prevalence of HBsAg, especially in the provinces of La Pampa (2.3%), Santa Cruz (2.2.%), and Tierra del Fuego (2.1.%). The prevalence ratio of HBsAg? among donors remained stable during the study period. Isolated HBc IgG-positive donors were only used for organ transplantation, among which 77% (252/328) were effective donors.
Conclusions: The prevalence of HBsAg in deceased donors in Argentina is low. Since the probability of being a donor is random, the prevalence in this population could be close to the real one in the country.
