Hepatitis B vaccination results in 140 liver transplant recipients.
OBJECTIVE
Human autologous liver transplantation is possible due to an adequate suppression of the body's immune response. This also causes a higher hepatitis infection rate, making hepatitis prevention very important.


METHODS
We describe our experience with hepatitis B virus vaccination in 140 adult liver transplant recipients, transplanted from 1986 to 1994 with more than one year of follow-up. Excluded were those who had hepatitis B surface antigens or antibodies to those antigens before the transplant. The vaccination schedule was 0-1-2 months with a double dose of recombinant vaccine.


RESULTS
The total response rate (surface antigen antibodies > 10 U) was 40% (56/140); the rate was 47.7% in men and 26% in women. At the end of the study, only 17.1% (24/140) of the patients had antibodies > 10 U. The response rate was higher in patients with antibodies to hepatitis B core antigen (66.6%) than in those lacking antibodies (31.7%), and more long lasting (42.4% vs 11.2%). The response rate in 116 patients with booster doses was 12.9%. Six correctly vaccinated patients (4.28%) acquired new hepatitis B virus infections after the operation.


CONCLUSIONS
The total response rate in these patients is much lower than in the general population, and there is a rapid decline of titers, probably due to immunosuppression. The role of booster doses in these patients should be clarified.
Loinaz
C
C
Servicio de Cirugia General, Hospital 12 de Octubre, Madrid, Spain.
de Juanes
J R
JR
Gonzalez
E M
EM
López
A
A
Lumbreras
C
C
Gómez
R
R
Gonzalez-Pinto
I
I
Jiménez
C
C
Garcia
I
I
Fuertes
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006509:Hepatitis B / Q000209:etiology / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D014611:Vaccination
D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines