In a recent study, Woll et al1 traced the source of hepatitis B viremia in two recipients of renal transplants to the transplanted kidney from a donor who was shown to be positive for hepatitis B core antigen. The viremia developed in both recipients within six months; their hepatitis B surface antigen (HBsAg), hepatitis B core antigen, and HBsAg subtypes were identical with those of the donor. Neither of the two received any transfusions during the peritransplant period.
This previously suspected but hitherto unproved role of the kidney as a vector for the hepatitis B virus is a relatively minor one, however. Only three (1.5%) of the 208 donors tested by Woll and associates were HBsAg positive. Still, even this low incidence was nine times higher than in their usual blood donor population. Might not then a screening test, as these investigators recommend, be advisable for all prospective kidney