[Experiences with liver transplantation in hepatitis B antigen positive liver cirrhosis].
From 1982 to January 1991 228 orthotopic liver transplantations (OLT) were performed in 213 patients with end-stage disease at the Vienna transplantation centre, 1st University Department of Surgery. 14 patients were serum HBV surface antigen (HBsAg) positive at the time of transplantation. In the first 4 patients only OLT was performed; postoperatively all grafts became reinfected and the patients developed chronic hepatitis. In a further series, immunoprophylaxis against hepatitis B virus reinfection was carried out with hyperimmuneglobulin. In 4 patients short-term immunoprophylaxis was performed; all of them were seronegative after OLT, but HBsAg ++reoccurred in the serum within 3-16 weeks after transplantation and all patients experienced reinfection of their graft. The 2 patients, who had been transplanted in a replicative state (HBeAg positive) showed a fatal course of hepatitis in the graft. Out of 6 patients given long-term immunoprophylaxis 3 cases showed stable liver function, without any signs of reinfection, and the HBsAg negative status remained for up to 19 months after transplantation. Since two patients displayed a HBV replicate status prior to transplantation, alpha interferon was administered preoperatively, which resulted in decreased serum HBV-DNA levels.
Steininger
R
R
I. Chirurgische Universitätsklinik, Wien.
Mühlbacher
F
F
Längle
F
F
Gnant
M
M
Sautner
T
T
Götzinger
P
P
Walgram
M
M
Penner
E
E
Radaszkiewicz
T
T
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000276:immunology / Q000401:mortality / Q000601:surgery*; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006513:Hepatitis B e Antigens / Q000032:analysis; D006521:Hepatitis, Chronic / Q000276:immunology / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007116:Immunization, Passive / Q000379:methods; D008103:Liver Cirrhosis / Q000276:immunology / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000276:immunology / Q000401:mortality; D015996:Survival Rate
D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens
Erfahrungen mit der Lebertransplantation bei Hepatitis-B-Antigen positiver Leberzirrhose.