Prevention of hepatitis B virus recurrence after living donor liver transplantation.
The emergence of lamivudine-resistant hepatitis B mutations is a major complication during pretransplantation treatment. The proper time to begin Lamivudine before transplantation is not yet known. Twenty-six patients received preoperative lamivudine treatment followed by combined lamivudine and hepatitis B immunoglobulin after transplantation up to December 2002. The length of preoperative lamivudine treatment ranged from 13 to 200 days (mean, 52 +/- 37 days). Hepatitis B virus-DNA was positive in 22 of 26 (84.6%) patients before preoperative lamivudine prophylaxis and persistently positive among only 4 of 22 patients (18%) who at transplantation did not show a viral mutation. In all patients, hepatitis B virus-DNA became negative immediately after transplantation. At a median follow-up of 34 months, neither a hepatitis B recurrence nor a mutation had occurred in any patient. The ability to schedule the proper time for preoperative lamivudine prophylaxis is an advantage of living donor liver transplantation.
Ali
H
H
Graduate School of Medicine, Department of Transplantation Immunology, Kyoto University, Kyoto 606-8507, Japan. hussein@kunp.kyoto-u.ac.jp
Egawa
H
H
Uryuhara
K
K
Ogawa
K
K
Kasahara
M
M
Ueda
M
M
Marusawa
H
H
Nabeshima
M
M
Tanaka
K
K
D000998:Antiviral Agents / Q000627:therapeutic use; D004279:DNA, Viral / Q000097:blood; D006509:Hepatitis B / Q000517:prevention & control* / Q000601:surgery*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D016031:Liver Transplantation / Q000502:physiology*; D019520:Living Donors; D011300:Preoperative Care; D012367:RNA, Viral / Q000097:blood / Q000302:isolation & purification; D012008:Recurrence; D012189:Retrospective Studies; D019562:Viral Load
D000998:Antiviral Agents; D004279:DNA, Viral; D012367:RNA, Viral; D019259:Lamivudine