Prevention of hepatitis B virus reinfection after orthotopic liver transplantation.
BACKGROUND
Hepatitis B virus reinfection is an important problem after liver transplantation. The aim of this study was to discuss the prevention of hepatitis B virus reinfection following orthotopic liver transplantation.


METHODS
Sixty-eight cases of chronic fulminant hepatitis B, end-stage liver cirrhosis, and liver carcinoma complicated with HBV cirrhosis were given anti-viral drugs before and after transplantation to prevent hepatitis B virus reinfection. Lamivudine was administered in 2 patients, lamivudine+hepatitis B immunoglobulin (HBIG) in 63, and adefovir+HBIG in 3. The measurement of serum HBV, HBV DNA, liver biopsy immunohistochemistry and clinical study were performed.


RESULTS
In 1 of the 2 patients who developed reinfection after lamivudine administration, serum HBsAg, HBeAb, HBcAb, HBV DNA were positive and liver biopsy immunohistochemistry showed HBsAg phenotype. In 2 of 63 patients who developed reinfection after use of lamivudine+HBIG, serum HBsAg, HBeAb, HBcAb were positive and liver biopsy immunohistochemistry showed HBsAg phenotype. Serum HBV DNA was positive in one of them. Three patients developed no reinfection with HBV after use of adefovir.


CONCLUSIONS
Orthotopic liver transplantation is effective in the treatment of HBV-infected diseases. Lamivudine+HBIG or adefovir+HBIG could effectively prevent hepatitis B virus reinfection.
Liver Transplantation Group of Transplantation Center, Changzheng Hospital, Second Military University, Shanghai 200003, China.
Zheng-Xin
ZX
Wang
Guo-Shan
GS
Ding
Hong
H
Fu
Jian-Jun
JJ
Zhang
Xiao-Song
XS
Chen
Wen-Yuan
WY
Guo
Xiao-Min
XM
Shi
Zhi-Ren
ZR
Fu
D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D006510:Hepatitis B Antibodies / Q000008:administration & dosage / Q000097:blood; D006512:Hepatitis B Core Antigens / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood / Q000276:immunology; D006513:Hepatitis B e Antigens / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000517:prevention & control* / Q000601:surgery*; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates; D011183:Postoperative Complications / Q000517:prevention & control / Q000821:virology; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage; D055502:Secondary Prevention
D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D063065:Organophosphonates; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; C053001:adefovir; D000225:Adenine