Prevention of hepatitis B virus reinfection after orthotopic liver transplantation

• Published in: Transplantation proceedings Vol. 36; no. 8; pp. 2315 - 2317
• Main Authors: Wang, Z.-X., Fu, Z.-R., Ding, G.-S., Zhang, J.-J., Fu, H., Zhang, M., Zhang, C.-Y.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2004; Elsevier Science
• Subjects: Adult; Biological and medical sciences; China - epidemiology; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Hepatitis B - epidemiology; Hepatitis B - mortality; Hepatitis B - prevention & control; Hepatitis B - surgery; Human viral diseases; Humans; Immunoglobulins - therapeutic use; Infectious diseases; Liver Function Tests; Liver Neoplasms - surgery; Liver Transplantation; Male; Medical sciences; Middle Aged; Recurrence; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Tissue, organ and graft immunology; Viral diseases; Viral hepatitis; Orthohepadnavirus; Hepatic disease; Homotransplantation; Reinfection; Infection; Virus; Viral hepatitis B; Medicine; Prevention; Orthotopic transplantation; Treatment; Hepadnaviridae; Surgery; Viral disease; Digestive diseases; Graft; Hepatitis B virus
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2004.07.070

We discuss the prevention of hepatitis B virus reinfection following orthotopic liver transplantation. Sixty-eight cases of chronic fulminant hepatitis B, the end stage of liver cirrhosis and liver carcinoma complicated with HBV cirrhosis, were given antiviral drugs pre- and posttransplantation to prevent hepatitis B virus reinfection. Lamivudine was administered to two cases and lamivudine + HBIG to 63 cases. Adefovir + HBIG was administered to three cases. The serum HBV, HBV DNA, liver biopsy immunohistochemistry and clinical examinations were performed. One of two cases given lamivudine developed reinfection with serum HBSAg, HbeAb, HBcAb, HBV DNA, and positive and liver biopsy immunohistochemistry showing HBSAg phenotype. Two of the 63 cases given lamivudine + HBIG developed reinfection with serum HBSAg, HBeAb, HBcAb positive and liver biopsy immunohistochemistry showing HBSAg phenotype. The serum HBV DNA was positive in one of the two cases. Three cases given adefovir developed no reinfection with HBV. Orthotopic liver transplantation is an effective treatment for HBV infection; lamivudine + HBIG or adefovir + HBIG prevent hepatitis B virus reinfection.