[Prolonged administration of hepatitis B hyperimmune gamma globulin in patients with liver transplantation in liver diseases caused by hepatitis B virus].
To prevent reinfection by the hepatitis B virus (HBV) in liver transplant patients, the administration of anti-HBV hyperimmune gammaglobulin (HBIg) was proposed. This study compares the efficacy of HBIg administration alone during the anhepatic phase of liver transplantation (group 1, 19 transplantations) with that obtained with prolonged and permanent HBIg administration (group II, 18 transplantations) in patients transplanted because of liver disease by HBV. HBIg was administered intravenously in the intrahospital phase, followed by intramuscular administration in the undefined follow up period. Thirteen patients (68%) of group 1 and 5 (28%) of group II developed post transplantation reinfection by HBV (p = 0.015). Survival of the grafts with reinfection by HBV was lower than that in grafts without reinfection (6/18, 33%, and 16/19, 84%; p = 0.002). Most grafts with reinfection by HBV were lost due to patient death as a consequence of this complication. No adverse secondary effects were found to be related with HBIg administration. In conclusion, the prolonged use of HBIg in patients undergoing liver transplantation because of liver disease by HBV reduces the risk of post transplant reinfection by HBV and is well tolerated.
Restrepo
J C
JC
Servicio de Hepatología, Hospital Clínic i Provincial, Universidad de Barcelona.
Rimola
A
A
Mas
A
A
Navasa
M
M
Salmerón
J M
JM
Cirera
I
I
García-Valdecasas
J C
JC
Grande
L
L
Visa
J
J
Rodés
J
J
D006085:Graft Survival; D006509:Hepatitis B / Q000601:surgery*; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000008:administration & dosage*; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D016031:Liver Transplantation; D012008:Recurrence; D013997:Time Factors
D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin
Administración prolongada de gammaglobulina hiperinmune antihepatitis B en pacientes con trasplante hepático por hepatopatía por virus de la hepatitis B.