Should liver transplantation be performed for patients with chronic hepatitis B? Yes!
The use of passive immunoprophylaxis to prevent HBV reinfection of the allograft following liver transplantation has led to a dramatic improvement in the outcome of patients who undergo transplantation for chronic hepatitis B. Hepatitis B previously was not one of our favorite diseases for which to perform liver transplantation. However, we now regard patients with this disease as good candidates for liver transplantation. I hope I have presented a compelling argument that no patient with hepatitis B, regardless of serological status, should be a priori denied liver transplantation. Studies from both the U.S. and Europe have shown that HBV reinfection can be prevented in almost all patients at a cost not out of line with other accepted indications for liver transplantation. Thus, I once again, ask the question, "Should patients with chronic hepatitis B undergo liver transplantation?" At our institution, the answer is an emphatic Yes!
Lake
J R
JR
Department of Medicine, University of California, San Francisco, USA.
D003362:Cost-Benefit Analysis; D004279:DNA, Viral / Q000032:analysis; D003657:Decision Making; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000150:complications / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins; D017093:Liver Failure / Q000209:etiology / Q000401:mortality / Q000601:surgery; D016031:Liver Transplantation / Q000191:economics / Q000401:mortality; D055502:Secondary Prevention; D015996:Survival Rate
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin