1 Liver Transplant Unit, The Newcastle upon Tyne Hospitals NHS Foundation Trust and Institute of Cellular Medicine, Newcastle University, United Kingdom.2 Liver Transplant Unit, Queen Elizabeth Hospital, Birmingham, United Kingdom.3 Virus Reference Department, National Infection Service, Public Health England/NHS Blood and Transplant, Colindale, London, United Kingdom.4 Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, Colindale, London, United Kingdom.5 Scottish Liver Transplant Unit, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.6 Liver Unit, St James' Hospital and University of Leeds, Leeds, UK.7 Division of Infection and Immunity, University College London and Blood Borne Virus Unit, Virus Reference Department, National Infection Service, Public Health England, Colindale, London, United Kingdom.8 South West Thames Renal & Transplantation Unit, Surrey, United Kingdom.
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The incidence and prevalence of hepatitis E virus (HEV) infection has increased in many developed countries over the last decade, predominantly due to infection with genotype 3 (G3) HEV. Infection with HEV G3 is important in transplant recipients because it can persist in immunosuppressed individuals, leading, if untreated, to the development of chronic hepatitis and significant liver fibrosis. The British Transplantation Society (BTS) has developed Guidelines for “Hepatitis E and Solid Organ Transplantation” to inform clinical teams and patients about hepatitis E, to help increase the recognition of persistent hepatitis E infection, and to provide clear guidance on its management. This guideline was published on the BTS website in June 2017 and aims to review the evidence relating to the diagnosis and management of persistent hepatitis E in solid organ transplant recipients and the methods of prevention of HEV infection. In line with previous guidelines published by the BTS, the guideline has used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system to rate the strength of evidence and recommendations. This article includes a summary overview of hepatitis E and transplantation with key references, and the statements of recommendation contained within the guideline. It is recommended that the full guideline document is consulted for complete details of the relevant references and evidence base. This may be accessed at https://bts.org.uk/guidelines-standards/.