{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:11:49Z","timestamp":1792649509109,"version":"4.5.0"},"reference-count":31,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Background: Hepatitis B virus (HBV) remains a leading etiology for liver transplantation (LT). In a large cohort of HBsAg-positive patients, this study evaluates long-term patient and graft survival after LT over the past 30 years while analyzing trends and outcomes following waiting list (WL) inclusion over the last 15 years. Methods: HBsAg-positive patients who underwent transplantation between 1991 and 2020 and were waitlisted from 2006 to 2020 at Padua Hospital were included in the analysis. Patients were stratified according to hepatitis delta virus (HDV) coinfection, transplant indication (decompensated cirrhosis vs. hepatocellular carcinoma (HCC)), and WL inclusion period. Results: Among 321 HBsAg-positive LT recipients (31.5% HDV-coinfected, 46.4% HCC), 1-year and 5-year patient\/graft survival rates were 87.6%\/86.7% and 82.6%\/82.2%, respectively. From 2006 to 2020, 284 HBsAg-positive patients were waitlisted (32.6% HDV-coinfected), with a significantly higher prevalence of HCC compared to non-HBV patients (p = 0.008). High-barrier nucleos(t)ide analogues (hbNUCs) significantly reduced mortality (p = 0.041) and improved survival post-WL inclusion (p = 0.007). Survival rates were consistent regardless of LT indication, HDV coinfection, or WL inclusion period. Post-transplant prophylaxis predominantly involved immunoglobulins (HBIG) + NUCs, resulting in only two cases of HBV reactivation, both clinically inconsequential. Conclusions: Over the past 30 years, HBV has remained a consistent indication for LT at our center. Thanks to hbNUCs, WL outcomes have improved and HCC has become the main indication for LT.<\/jats:p>","DOI":"10.3390\/v17040454","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T11:06:48Z","timestamp":1742555208000},"page":"454","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Chronic Hepatitis B in the Transplant Setting: A 30-Year Experience in a Single Tertiary Italian Center"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4127-8941","authenticated-orcid":false,"given":"Francesco Paolo","family":"Russo","sequence":"first","affiliation":[{"name":"Gastroenterology and Multivisceral Transplant Unit, Azienda Ospedale\u2014Universit\u00e0 di Padova, 35125 Padua, Italy"},{"name":"Department of Surgery, Oncology and Gastroenterology, University of Padua, 35125 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0326-7088","authenticated-orcid":false,"given":"Sara","family":"Battistella","sequence":"additional","affiliation":[{"name":"Gastroenterology and Multivisceral Transplant Unit, Azienda Ospedale\u2014Universit\u00e0 di Padova, 35125 Padua, Italy"},{"name":"Department of Surgery, Oncology and Gastroenterology, University of Padua, 35125 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6734-7178","authenticated-orcid":false,"given":"Alberto","family":"Zanetto","sequence":"additional","affiliation":[{"name":"Gastroenterology and Multivisceral Transplant Unit, Azienda Ospedale\u2014Universit\u00e0 di Padova, 35125 Padua, Italy"},{"name":"Department of Surgery, Oncology and Gastroenterology, University of Padua, 35125 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0101-1938","authenticated-orcid":false,"given":"Martina","family":"Gambato","sequence":"additional","affiliation":[{"name":"Gastroenterology and Multivisceral Transplant Unit, Azienda Ospedale\u2014Universit\u00e0 di Padova, 35125 Padua, Italy"},{"name":"Department of Surgery, Oncology and Gastroenterology, University of Padua, 35125 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3248-2038","authenticated-orcid":false,"given":"Alberto","family":"Ferrarese","sequence":"additional","affiliation":[{"name":"Gastroenterology and Multivisceral Transplant Unit, Azienda Ospedale\u2014Universit\u00e0 di Padova, 35125 Padua, Italy"},{"name":"Department of Surgery, Oncology and Gastroenterology, University of Padua, 35125 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Germani","sequence":"additional","affiliation":[{"name":"Gastroenterology and Multivisceral Transplant Unit, Azienda Ospedale\u2014Universit\u00e0 di Padova, 35125 Padua, Italy"},{"name":"Department of Surgery, Oncology and Gastroenterology, University of Padua, 35125 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Senzolo","sequence":"additional","affiliation":[{"name":"Gastroenterology and Multivisceral Transplant Unit, Azienda Ospedale\u2014Universit\u00e0 di Padova, 35125 Padua, Italy"},{"name":"Department of Surgery, Oncology and Gastroenterology, University of Padua, 35125 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Mescoli","sequence":"additional","affiliation":[{"name":"Department of Medicine, (Pathology Section), University Hospital of Padua, 35125 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Piano","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padua, 35125 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3114-8521","authenticated-orcid":false,"given":"Francesco Enrico","family":"D\u2019Amico","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology, University of Padua, 35125 Padua, Italy"},{"name":"General Surgery 2, Azienda Ospedale\u2014Universit\u00e0 di Padova, 35125 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4548-8308","authenticated-orcid":false,"given":"Alessandro","family":"Vitale","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology, University of Padua, 35125 Padua, Italy"},{"name":"General Surgery 2, Azienda Ospedale\u2014Universit\u00e0 di Padova, 35125 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3459-7306","authenticated-orcid":false,"given":"Enrico","family":"Gringeri","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology, University of Padua, 35125 Padua, Italy"},{"name":"General Surgery 2, Azienda Ospedale\u2014Universit\u00e0 di Padova, 35125 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Feltracco","sequence":"additional","affiliation":[{"name":"Anaesthesia and Intensive Care, Department of Medicine, Padua University Hospital, 35125 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Angeli","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padua, 35125 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2310-0245","authenticated-orcid":false,"given":"Umberto","family":"Cillo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology, University of Padua, 35125 Padua, Italy"},{"name":"General Surgery 2, Azienda Ospedale\u2014Universit\u00e0 di Padova, 35125 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8791-191X","authenticated-orcid":false,"given":"Patrizia","family":"Burra","sequence":"additional","affiliation":[{"name":"Gastroenterology and Multivisceral Transplant Unit, Azienda Ospedale\u2014Universit\u00e0 di Padova, 35125 Padua, Italy"},{"name":"Department of Surgery, Oncology and Gastroenterology, University of Padua, 35125 Padua, 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