[Ambulatory management of hepatitis B before and after liver transplantation].
METHODS
A 48-year-old patient from Pakistan was referred with scleral icterus, ascites and lower limb edema.


METHODS
The patient was suffering from post-hepatitis liver cirrhosis, CHILD stage B, with underlying chronic hepatitis B and C coinfection.


METHODS
One year after diagnosis, orthotopic liver transplantation (OLT) was performed. To avoid recurrence of the hepatitis B in the transplant, the patient was given a treatment with lamivudine preoperatively. A prophylaxis with a combination of lamivudine and hepatitis B immunoglobulin peri- and postoperatively has been given for more than 5 years.


CONCLUSIONS
The use of lamivudine and hepatitis B immunoglobulin improves transplant survival in patients who have undergone OLT on the basis of post-hepatitis liver cirrhosis secondary to chronic hepatitis B. Costs are reduced by administering the hepatitis B immunoglobulin intramuscularly and by managing the preoperative and aftercare of the patient on an outpatient basis.
Küppers
B
B
Gastroenterologische Schwerpunktpraxis Drs. Küppers and Mickisch and Baniewicz, Mannheim. info@gastroenterologie-mannheim.de
Otto
G
G
Bartel
J
J
Otto
H F
HF
D000553:Ambulatory Care / Q000191:economics; D000998:Antiviral Agents / Q000627:therapeutic use*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000008:administration & dosage / Q000627:therapeutic use; D007273:Injections, Intramuscular; D019259:Lamivudine / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000191:economics; D011292:Premedication; D011300:Preoperative Care / Q000191:economics; D055502:Secondary Prevention
D000998:Antiviral Agents; D007136:Immunoglobulins; D019259:Lamivudine; C045213:hepatitis B hyperimmune globulin