Evidence map›Paper›PMID 41427832›Full record

SynthesisTransplantation2026

Transmission Risk of Intentional Transplantation of Kidneys From Donors With Active Hepatitis B to Recipients Without Active Hepatitis B: A Systematic Review and Meta-Analysis.

Karen M J Waller, Nicole De La Mata, James A Hedley, Trishala Sharma, Rachel Davies, Emma Garrett, Sarah White, William Rawlinson, Sacha Stelzer-Braid, Kate Wyburn and 1 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Karen M J WallerCollaborative Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Nicole De La MataCollaborative Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
James A HedleyCollaborative Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Trishala SharmaCollaborative Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Rachel DaviesCollaborative Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Emma GarrettCollaborative Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Sarah WhiteCollaborative Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
William RawlinsonSerology and Virology Division (SAViD), NSW Health Pathology Randwick Prince of Wales Hospital, Sydney, NSW, Australia.
Sacha Stelzer-BraidSerology and Virology Division (SAViD), NSW Health Pathology Randwick Prince of Wales Hospital, Sydney, NSW, Australia.
Kate WyburnCollaborative Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Angela C WebsterCollaborative Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPotential kidney donors with active hepatitis B virus (HBV: positive hepatitis B surface antigen [HBsAg] and/or nucleic acid test [NAT]) are usually declined for HBsAg-negative recipients. Safety may be improved by recipient vaccination and/or antivirals, thereby increasing transplantation opportunities. We quantified HBV transmission risk in this setting to inform donation decisions.

methodsSystematic review and meta-analysis (MEDLINE, to November 2024) of cohorts comprised of kidney donors with active HBV intentionally used for HBsAg-negative recipients. Transmission was defined as new HBsAg or NAT positivity posttransplant. Transmission proportions and exact 95% confidence intervals (CIs) were pooled using generalized linear mixed models with logistic transformation and random effects.

resultsWe included 20 cohorts involving 600 HBsAg-negative recipients from donors with active HBV. Most donors were living (52%), with negative NAT (60%). Most recipients had positive surface antibody (>10 IU/L, 86%); many were core antibody positive (47%). Antiviral prophylaxis was given to 49% recipients, varying in type, duration, and strategy. There were 29 of 600 HBV transmissions, mostly transient low-level viremia only (62%). The pooled transmission rate was 4.0% (95% CI, 1.8%-8.3%) with low heterogeneity ( I2  = 0%) but some between-study variance (Tau 2  = 1.21). Transmission rates were higher where all donors had positive NAT (16.0%; 95% CI, 10.2%-24.3%), and lower where all recipients were living (0.8%; 95% CI, 0.1%-6.4%) or had positive surface antibody (1.4%; 95% CI, 0.2%-8.8%). Three deaths because of HBV transmissions occurred, all among recipients not taking posttransplant antiviral prophylaxis.

conclusionsGiven low transmission rates and mitigating strategies, kidney transplantation may be considered from donors with active HBV, with donor/recipient risk stratification, consent, and monitoring/prophylaxis.

Indexed as

Donor SelectionHepatitis BHepatitis B virusKidney TransplantationTissue DonorsAntiviral AgentsHepatitis B Surface AntigensHumansRisk AssessmentRisk FactorsTransplant RecipientsAntiviral AgentsHepatitis B Surface Antigens

Identifiers

PMID41427832
PMCPMC12998773

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.