Donor or Recipient Hepatitis B Seropositivity Is Associated With Allograft Vasculopathy

Haji, Showkat A.; Avery, Robin K.; Yamani, Mohamad H.; Tuzcu, E. Murat; Crowe, Timothy D.; Cook, Daniel J.; Mawhorter, Steven D.; Hobbs, Robert; Young, James B.; Smedira, Nicholas; Starling, Randall C.

doi:10.1016/j.healun.2005.10.007

« Previous Next »The Journal of Heart and Lung Transplantation
Volume 25, Issue 3 , Pages 294-297, March 2006

Donor or Recipient Hepatitis B Seropositivity Is Associated With Allograft Vasculopathy

Showkat A. Haji, MD
- Department of Cardiology, Tulane University Medical Center, New Orleans, Louisiana
- Reprint requests: Showkat A Haji, MD, Tulane University Medical Center, 1430 Tulane Avenue, SL48, New Orleans, LA 70112. Telephone: 504-988-5263
Robin K. Avery, MD
- Department of Infectious Disease, Kaufman Center for Heart Failure, Cleveland Clinic Foundation, Cleveland, Ohio, USA
Mohamad H. Yamani, MD
- Department of Cardiovascular Medicine, Kaufman Center for Heart Failure, Cleveland Clinic Foundation, Cleveland, Ohio, USA
E. Murat Tuzcu, MD
- Department of Cardiovascular Medicine, Kaufman Center for Heart Failure, Cleveland Clinic Foundation, Cleveland, Ohio, USA
Timothy D. Crowe, MS
- Department of Cardiovascular Medicine, Kaufman Center for Heart Failure, Cleveland Clinic Foundation, Cleveland, Ohio, USA
Daniel J. Cook, PhD
- Allogen Laboratory, Kaufman Center for Heart Failure, Cleveland Clinic Foundation, Cleveland, Ohio, USA
Steven D. Mawhorter, MD
- Department of Infectious Disease, Kaufman Center for Heart Failure, Cleveland Clinic Foundation, Cleveland, Ohio, USA
Robert Hobbs, MD
- Department of Cardiovascular Medicine, Kaufman Center for Heart Failure, Cleveland Clinic Foundation, Cleveland, Ohio, USA
James B. Young, MD
- Department of Cardiovascular Medicine, Kaufman Center for Heart Failure, Cleveland Clinic Foundation, Cleveland, Ohio, USA
Nicholas Smedira, MD
- Department of Cardiothoracic Surgery, Kaufman Center for Heart Failure, Cleveland Clinic Foundation, Cleveland, Ohio
Randall C. Starling, MD MPH
- Department of Cardiovascular Medicine, Kaufman Center for Heart Failure, Cleveland Clinic Foundation, Cleveland, Ohio, USA

Received 14 June 2005; received in revised form 18 August 2005; accepted 13 October 2005. published online 06 January 2006.

Background

Increasing interest has focused on possible viral triggers of cardiac allograft vasculopathy. Although much interest has centered on cytomegalovirus, it has recently been noted that donor hepatitis C seropositivity is associated with risk for accelerated vasculopathy. The current study hypothesized that hepatitis B (HBV) might be associated with accelerated vasculopathy.

Methods

Sixty-six patients who received heart transplants between September 1998 and July 2000 were analyzed by intravascular ultrasound within 6 weeks and again at 12 months after transplantation. These patients were divided into 2 groups: the HBV Group (n = 13) in which either the donor or recipient was seropositive for hepatitis B core antibody (HBcAb), and a Control Group (n = 53) in which neither donor nor recipient was positive for HBcAb.

Results

Baseline characteristics of the 2 groups were similar. The HBV Group had significant increase in the change in average intimal area (1.59 ± 1.4 vs 0.46 ± 0.4 mm², p = 0.01) per mm length of the vessel compared with controls. Allograft vasculopathy at 1 year (defined as largest maximal intimal thickness increase of ≥0.50 mm) occurred in 46% of the HBV group compared with 24% of the control group (p = 0.05). When measured as an average maximal intimal thickness increase of >0.30 mm, allograft vasculopathy at 1 year occurred in 31% of the HBV Group compared with 5% of Controls (p = 0.01).

Conclusions

These preliminary results suggest that HBV seropositivity in donor or recipient may be associated with an increased risk for cardiac allograft vasculopathy.