{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T13:17:43Z","timestamp":1779110263988,"version":"3.51.4"},"reference-count":31,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Hepatitis B virus (HBV) transmission risk from donors with resolved HBV infection remains a concern in kidney transplantation, because covalently closed circular deoxyribonucleic acid (DNA) may persist despite serological recovery. In this study, we evaluated the transmission risk from anti-hepatitis B core antibody (anti-HBc)-positive, hepatitis B surface antigen (HBsAg)-negative, and HBV-DNA-negative living donors to anti-HBc-negative recipients. Methods: We retrospectively reviewed living-donor kidney transplantations performed at our institution (June 2011\u2013December 2024). Among 277 transplantations, 26 met the inclusion criteria. All recipients had received HBV vaccination prior to transplantation. Serological markers, including HBsAg, anti-HBc, anti-hepatitis B surface antibody (anti-HBs), and HBV-DNA, were monitored before and after transplantation. Results: Five recipients (19.2%) achieved anti-HBs seroconversion after vaccination pre-transplantation, but all lost protective antibody levels before or shortly after transplantation. Five recipients (19.2%) showed transient post-transplantation anti-HBs positivity; three cases were considered vaccine-related, and two were possibly transplant-related. None of the patients developed liver enzyme elevation, clinical hepatitis, HBsAg positivity, or anti-HBc seroconversion. Among the four recipients tested for HBV-DNA, all results remained undetectable throughout follow-up. None of the recipients maintained protective anti-HBs levels pre- or post-transplantation, despite universal vaccination. Two recipients (7.7%) developed delayed anti-HBs positivity without anti-HBc seroconversion, HBsAg positivity, or detectable HBV-DNA, suggesting possible subclinical HBV antigen exposure from the allograft. Conclusions: Kidney transplantation from donors with resolved HBV infection was not associated with clinically evident HBV infection, although transient serological changes were observed. Optimized vaccination strategies and structured post-transplant monitoring may enhance the safety of transplantations involving such donors.<\/jats:p>","DOI":"10.3390\/jcm15103846","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T12:36:40Z","timestamp":1779107800000},"page":"3846","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Kidney Transplantation from Donors with Resolved HBV Infection: Minimal but Potential Transmission Risk and the Need for Improved Recipient Vaccination"],"prefix":"10.3390","volume":"15","author":[{"given":"Taeko","family":"Sasaki","sequence":"first","affiliation":[{"name":"Department of Surgery, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto 861-8520, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4372-0011","authenticated-orcid":false,"given":"Shigeyoshi","family":"Yamanaga","sequence":"additional","affiliation":[{"name":"Department of Surgery, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto 861-8520, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0934-311X","authenticated-orcid":false,"given":"Yuji","family":"Hidaka","sequence":"additional","affiliation":[{"name":"Department of Surgery, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto 861-8520, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoei","family":"Miyabe","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto 861-8520, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiaki","family":"Kawabata","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto 861-8520, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariko","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto 861-8520, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Urology, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto 861-8520, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiro","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Urology, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto 861-8520, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akito","family":"Inadome","sequence":"additional","affiliation":[{"name":"Department of Urology, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto 861-8520, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Yokomizo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto 861-8520, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1056\/NEJM199912023412303","article-title":"Comparison of Mortality in All Patients on Dialysis, Patients on Dialysis Awaiting Transplantation, and Recipients of a First Cadaveric Transplant","volume":"341","author":"Wolfe","year":"1999","journal-title":"N. 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