The Annals of Thoracic Surgery, Vol 49, 802-805, Copyright © 1990 by The Society of Thoracic Surgeons
Use of aortic valve allografts from hepatitis B surface antigen- positive donors
A Morris, MG Strickett and BG Barratt-Boyes
Microbiology Department, Green Lane Hospital, Auckland, New Zealand.
Over a 28-month period, 31 patients undergoing aortic valve replacement
received valve allografts from hepatitis B surface antigen-positive,
hepatitis B e antigen-negative donors. At the time of operation, 22
recipients were immune to hepatitis B infection; 19 had antibodies to
hepatitis B surface antigen, and 3 were hepatitis B surface antigen
positive. Nine patients were regarded as being susceptible to hepatitis B;
7 lacked hepatitis B markers, and records of serological status could not
be found for the other 2. Four of the susceptible patients received
hepatitis B immunoglobulin postoperatively, and 1 of them also received one
10-micrograms dose of hepatitis B vaccine. The 9 susceptible patients
underwent hepatitis B serological studies a mean of 17 months (range, 4 to
31 months) postoperatively. In only 1 patient, tested 29 months after
operation, had antibodies to hepatitis B surface, hepatitis B core, and
hepatitis B e antigens developed. He had not experienced a clinical episode
of hepatitis, and results of liver function tests were normal. He had not
received prophylaxis. Because hepatitis B virus may be transmitted by
hepatitis B surface antigen-positive, hepatitis B e antigen-negative
valves, prophylaxis should be given whenever they are used and follow-up
serological studies undertaken.
