Utilization of Hepatitis B Virus NAT+ Donors for Hepatitis B Vaccinated Lung Transplant Candidates

Exclusion Criteria

• •Donor characteristics:
• •* Donation after circulatory death donor
• •* Hepatitis C Virus (HCV) NAT+
• •* PaO2/FiO2 \<300 on FiO2 = 100% and PEEP=5
• •* Age \>55 years
• •* Smoking history \>20 pack years
• •Transplant candidate characteristics:
• •* Age \>70 years
• •* Any chronic liver disease (excluding non-alcoholic fatty liver disease (NAFLD)) associated with persistently elevated liver enzymes
• •* Significant fibrosis (≥F2 on Fibroscan or Fib4 ≥1.67 (for patients unable to complete Fibroscan and without liver disease risk factors))
• •* Inadequate insurance coverage of entecavir, tenofovir disoproxil, or tenofovir alafenamide
• •* Retransplant candidate
• •* Current use of extracorporeal membrane oxygenation (ECMO) or mechanical ventilation as a bridge to lung transplantation
• •* HIV infection
• •* Chronic kidney disease with estimated glomerular filtrate rate less than 50 ml/min/1.73 m2
• •* Small bowel dysmotility or plan for prolonged medications and/or nutrition via tube route in the post-transplant period
• •* Significant human leukocyte antibody (HLA) sensitization (Calculated Panel Reactive Antibody (CPRA) ≥60%)
• •* Planned or high likelihood of anti-thymocyte globulin induction immunosuppression or rituximab treatment
• •* Known hypercoagulable states including positive antiphospholipid antibodies with prior venous or arterial thromboembolic events or Factor V Leiden or Prothrombin mutations with or without prior venous or arterial thromboembolic events
• •* History of hypersensitivity or anaphylactic reaction to immune globulin or similar products
• •* Receiving or anticipated to receive drugs with significant entecavir or tenofovir interactions including phenytoin/fosphenytoin, oxcarbazepine, phenobarbital, primidone, rifabutin, and rifampin