Abstract: Objective To observe the decline of post-operative hepatitis B virus surface antibody (HBsAb) titer and evaluate its influential factors in pediatric recipients receiving hepatitis B core antibody (HBcAb) positive grafts. Methods Sixty recipients who were operated in Tianjin First Center Hospital from September 2016 to December 2017 were enrolled in the study. The recipients were divided into three groups according to the changes of HBsAb titer three months after liver transplantation: group A (HBsAb titer > 1 000 IU/L, n=18), group B (200 IU/L ≤ HBsAb titer ≤ 1 000 IU/L, n=18) and group C (HBsAb titer < 200 IU / L, n=24). The donor and recipient characteristics, peri-operative data, post-operative complications, de novo hepatitis B along with graft and recipient survival rates were compared between three groups. Logistic analysis was used to analyze the influencing factors for HBsAb titer decline. Results The median follow-up time was 17.8 months for all recipients. One patient died of interstitial pneumonia in group C. One patient developed de novo hepatitis B in group C. No cases of recipient death and de novo hepatitis B in group A and B. There were no differences in de novo hepatitis B (χ2=1.525, P=0.466), and recipient survival rates between three groups (Log-rank χ2=1.665, P=0.625). Recipients receiving living-related grafts (OR=10.82, 95%CI: 1.17-100.50) and more than 400 mL plasma transfusion during operation (OR=6.25, 95%CI: 1.51-25.87) were risk factors for the decline of HBsAb titer after operation. Conclusion The graft type and intraoperative plasma transfusion influence the decline of HBsAb titer after transplantation.

Key words: liver transplation, child, hepatitis B, hepatitis B core antibody, hepatitis B surface antibody