Passive immunoprophylaxis after liver transplantation in HBsAg-positive patients.
110 HBsAg-positive patients underwent orthotopic liver transplantation and received long-term anti-hepatitis B virus (HBV) passive immunoprophylaxis with anti-HBs immunoglobulin. During a mean follow-up period of 20 months, all patients became HBsAg negative after transplantation but circulating HBsAg reappeared in 25 (22.7%). Overall 1-year survival was 83.6% and overall 2 year actuarial recurrence of HBsAg was 29% (59% after posthepatitis B cirrhosis, 13% after posthepatitis B-delta cirrhosis, and 0% after fulminant hepatitis B). Patients with HBV cirrhosis who were HBV-DNA positive had a much greater risk of HBsAg recurrence than patients who were HBV-DNA negative (96% vs 29% at 2 years). Reappearance of HBsAg was associated with evidence of HBV replication and abnormal histological findings in the graft. Long-term passive anti-HBV immunoprophylaxis significantly reduced HBV reinfection and improved survival in patients without evidence of active HBV replication before orthotopic liver transplantation.
Samuel
D
D
Hepatobiliary Surgery and Liver Transplantation Research Unit, Paris South University, France.
Bismuth
A
A
Mathieu
D
D
Arulnaden
J L
JL
Reynes
M
M
Benhamou
J P
JP
Brechot
C
C
Bismuth
H
H
D000293:Adolescent; D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival / Q000276:immunology; D006509:Hepatitis B / Q000276:immunology / Q000401:mortality / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000276:immunology*; D006514:Hepatitis B Surface Antigens / Q000276:immunology*; D006513:Hepatitis B e Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics; D006801:Humans; D007116:Immunization, Passive / Q000379:methods*; D007165:Immunosuppression Therapy; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D016019:Survival Analysis
D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens