{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:25:58Z","timestamp":1789053958442,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In nonendemic areas, transplantation from donors with hepatitis B virus (HBV) to recipients without HBV (D+\/R\u2212) has been proposed to expand the donor pool; however, data are limited. We aimed to evaluate the epidemiology of HBV in thoracic organ donors, assess HBV\u2010related thoracic organ nonuse, and determine the impact of HBV D+\/R\u2212 in recipient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult first\u2010time heart and lung transplant recipients with negative hepatitis B surface antigen (HBsAg) and HBV nucleic acid testing (NAT) were identified through the Organ Procurement and Transplantation Network between January 2004 and December 2022. Multivariable Cox regression models were built to assess the relationship of donor HBV status with death and graft failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our final cohort included 64,514 thoracic organ transplant recipients, 53 HBV D+\/R\u2212 (0.1%) versus 64,461 (99.9%) HBV D\u2212\/R\u2212, including 34,547 (53.5%) heart and 29,967 lung (46.5%) transplants. Donors with positive HBsAg or HBV NAT tests represented 0.31% of the donor pool. There were no reported cases of thoracic organ nonuse due to hepatitis, nor were there differences in the rates of HBV\u2010NAT or HBsAg positivity in used versus nonused thoracic organs. In multivariable modeling, HBV D+\/R\u2212 was not associated with increased hazard of death (adjusted hazard ratio (aHR), 0.80 [95% CI, 0.30\u20132.13],\n                      <jats:italic>p<\/jats:italic>\n                      = 0.652) or graft failure (aHR, 0.73 [95% CI, 0.27\u20131.93],\n                      <jats:italic>p<\/jats:italic>\n                      = 0.522) at 1\u2010year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HBV D+\/R\u2212 thoracic organ transplantation does not appear to have a deleterious impact on recipient or graft survival. However, more data are needed to determine the long\u2010term risk of donor\u2010derived HBV infection and define the optimal management strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.70054","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T12:49:42Z","timestamp":1753188582000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Hepatitis B Virus Donor Positive to Recipient Negative (D+\/R\u2212) Heart and Lung Transplantation: Analysis From the Organ Procurement and Transplantation Network"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1725-1407","authenticated-orcid":false,"given":"Sara","family":"Belga","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases University of British Columbia  Vancouver British Columbia Canada"},{"name":"Immunity &amp; Infection Research Centre Vancouver Coastal Health Research Institute  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C.","family":"Wright","sequence":"additional","affiliation":[{"name":"Faculty of Pharmaceutical Sciences University of British Columbia  Vancouver British Columbia Canada"},{"name":"British Columbia Children's Hospital Research Institute  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6253-293X","authenticated-orcid":false,"given":"Stephen B.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases University of Saskatchewan  Saskatoon Saskatchewan Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2605-9257","authenticated-orcid":false,"given":"Christine M.","family":"Durand","sequence":"additional","affiliation":[{"name":"The Johns Hopkins Transplant Research Center  Baltimore Maryland USA"},{"name":"Department of Medicine Division of Infectious Diseases Johns Hopkins School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Doucette","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","unstructured":"E.Eichenberger G.Vece S.Kakoullis J.Steinbrink J.Reynolds andCWolfe \u201cViremic Hepatitis B Donors: A Case of Why It's Time to Further Expand the Donor Pool for Thoracic Transplant \u201d Presented at:ISHLT 40th Annual Meeting Abstracts;2020 https:\/\/www.jhltonline.org\/article\/S1053\u20102498(20)31165\u20107\/abstract.","DOI":"10.1016\/j.healun.2020.01.1148"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13187"},{"key":"e_1_2_10_4_1","unstructured":"Guidelines for Hepatitis B & Solid Organ Transplantation.British Transplantation Society2018 https:\/\/bts.org.uk\/wp\u2010content\/uploads\/2018\/03\/BTS_HepB_Guidelines_FINAL_09.03.18.pdf."},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2004.08.112"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2012.03.040"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15886"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr\u20102023\u2010255663"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/003335491312800403"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6904a1"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v7.i2.189"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13514"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1053\u20102498(01)00280\u20107"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000004759"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2022.10.078"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad201"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.70013"}],"container-title":["Transplant Infectious 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