A concise update on the status of liver transplantation for hepatitis B virus: the challenges in 2002.
Significant improvements in both patient and graft survival after orthotopic liver transplantation (OLT) for hepatitis B virus (HBV)-related liver failure have been made during the last decade. Recurrence of HBV infection has decreased, even in high-risk patients. Despite ongoing progress, challenges remain for the next millennium, including the determination of cost-effective dosing strategies, treatment of HBV infection in liver transplant recipients, and ramifications of the use of new antiviral agents, specifically, the appearance of resistant strains. This review summarizes the relevant history of OLT for chronic viral hepatitis B, details accepted preventive and therapeutic treatments, and discusses ongoing experimental trials. Emphasis also is placed on new approaches in transplantation as they impact on the care of HBV-infected patients.
Vargas
Hugo E
HE
Division of Transplantation Medicine, Mayo Clinic Scottsdale, Phoenix, AZ 85054, USA. vargas.hugo@mayo.edu
Dodson
Forrest S
FS
Rakela
Jorge
J
D004279:DNA, Viral / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D016031:Liver Transplantation / Q000191:economics; D012008:Recurrence
D004279:DNA, Viral; D007136:Immunoglobulins; D019259:Lamivudine; C045213:hepatitis B hyperimmune globulin