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

What was studied

This review looked at hepatitis B (HBV) positive kidneys given to transplant recipients. The recipients did not have virus in the blood. PubMed and Embase were searched. The cut-off was November 2025. The team looked for recipients of kidneys that were HBsAg positive or viremic. The meta-analysis used studies with a comparison group. That group had HBV negative kidneys. The studies had to report patient and graft survival. Risk ratios were pooled at 1, 3 and 5 years. Viral transmission was also reviewed. The meta-analysis pooled 6 studies. It covered 638 recipients of HBV positive kidneys. It also covered 2800 recipients of HBsAg negative, non-viremic kidneys.

What they found

Graft survival did not differ between the 2 groups. At 1 year, the risk ratio was 1. At 3 years it was 1.01. At 5 years it was 1.00. The ranges were 0.98-1.01, 0.98-1.04 and 0.91-1.09. Patient survival was comparable too. The HBV transmission rate was low, at 4.94. It was lower when prophylaxis was used. It was also lower when recipients were immune before transplant.

What it means for patients

The authors say kidneys from HBV infected donors give similar patient and graft survival. They say such kidneys may be used to widen the donor pool. This is in immune recipients with appropriate prophylaxis. They note the evidence of safety is new. Reported transmission rates are very low.

Why it is not certain yet

Only 6 studies went into the meta-analysis. The authors call the evidence on safety emerging. Transmission was low but did occur. A review can only be as good as the studies in it.

Source

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

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