P894 PROPHYLAXIS OF DE NOVO HEPATITIS B VIRUS INFECTION WITH LAMIVUDINE IN HBsAg-NEGATIVE NAIVE RECIPIENTS OF HEPATITIS B CORE ANTIBODY-POSITIVE LIVERS: A 13-YEAR SINGLE-CENTER EXPERIENCE

Methods: • Patients: Consecutive outpatient LT recipients between January and December 2012 • Reference group G0: – >2-fold increase in liver function tests (LFT) or unexplained fibrosis >7kPa (Fibroscan) – Excluded: ischemic cholangiopathy, HBV, HVC, HVE post LT infections. • Control groups: – G1:primary LT, normal LFT – G2:primary LT, abnormal LFT – G3: HCV post-LT Patients were tested for donor specific antibodies (DSA) (Luminex SA), and the results expressed in MFI. Comparison of prevalence of DSA and MFI between G0 and control groups was made. Results: 91pts including 22 pts in G0 and 31, 19, 16 pts in G1, G2, G3 were investigated 9.6 yrs after LT. Fourteen (18.7%) pts had been re-transplanted. DSA were found in 95.5% in G0, anti class II in all cases, vs 50.9% in G1-G3 (p < 0.001). Prevalences of DSA in G1, G2 and G3 were 45.2, 52.6 and 68.8% (p =0.003), respectively. In pts with DSA, median MFI was 9916 in G0 vs 3443 in G0-G3 (p =0.02). Conclusions: Prevalence of DSA (95%) and MFI in G0 patients are significantly higher than in control groups. This highly suggests a role of AMR in long-term unexplained liver graft dysfunctions. In HCV positive pts, the prevalence of DSA was also found high and raises the issue of HCV as a contributor anti-HLA sensitization.