Hepatitis B
1. HBsAg -, HBcAb + renal tx recipients
- Before renal transplant surgery, if time allows, check the HBsAb levels and give a booster dose if levels are <10 mIU/mL; otherwise, give a booster dose regardless of HBsAb levels unless one was given in the previous 8 weeks.
- Monitor HBsAg monthly for the first 3 months post-transplant surgery, and every 3-4 months subsequently for at least a year.
2. HBsAg -, HBcAb- renal tx recipient with HBsAg -, HBcAb + renal donor
- Before renal transplant surgery, if time allows, check the HBsAb levels and give a booster dose if levels are <10 mIU/mL; otherwise, give a booster dose regardless of HBsAb levels unless one was given in the previous 8 weeks.
- At the time of renal transplant surgery, give HBV immunoglobulin (HBIG) according to the following schedule:
- HBIG 4,000 IU iv stat.
Measure HBsAb levels at day 7 and repeat dose if levels are <500 mIU/mL.
Monitor HBsAg monthly for the first 3 months post-transplant surgery, and every 3-4 months subsequently for at least a year.