Lamivudine in prevention and treatment of recurrent HBV after liver transplantation.
BACKGROUND
Chronic hepatitis B virus infection is one of the major causes of liver cirrhosis worldwide, especially in Asia. Liver transplantation for the end-stage liver disease with hepatitis B virus(HBV) is commonly complicated by the recurrence of HBV. The present study was designed to evaluate lamivudine in the prevention and treatment of recurrent HBV after liver transplantation.


METHODS
Seventeen patients with HBV-related liver disease in a total of 41 patients have received liver transplantation at our hospital since 2001. All the patients were HBV positive before transplantation, 5 of them had acute liver failure. Artificial liver was used in 4 patients with acute liver failure. All of the patients received lamivudine at a dose of 100 mg/d after liver transplantation. Lamivudine and HBIg therapy were given to 3 patients.


RESULTS
Liver transplantation was successfully performed in all 17 patients. Three patients died of complications 3-6 months after the transplantation. One patient withdraw from lamivudine therapy and died of liver failure at 14 months after the transplantation. Thirteen patients were followed up from 6 to 18 months. Two viremic patients had HBV recurrence shortly after the transplantation. Two viremic patients who had received HBIg and lamivudine after the transplantation had no evidence of HBV recurrence.


CONCLUSIONS
Lamivudine therapy is effective in preventing HBV recurrence after liver transplantation. The recurrence of HBV is closely related to HBV DNA status before liver transplantation.
Lu
Yi
Y
Department of Hepatobiliary Surgery, First Hospital of Xi'an Jiaotong University, Xi'an 710061, China. Lvyi@newliver.net
Wang
Bo
B
Yu
Liang
L
Liu
Chang
C
Wu
Zheng
Z
Pan
Cheng-En
CE
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000188:drug therapy* / Q000517:prevention & control*; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D055502:Secondary Prevention; D016896:Treatment Outcome
D007136:Immunoglobulins; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; C045213:hepatitis B hyperimmune globulin