Advances in prophylaxis and treatment of recurrent hepatitis B after liver transplantation.
BACKGROUND
In the 1990s, liver transplantation for hepatitis B virus (HBV) related-liver diseases was a very controversial issue because the graft was inevitably recurrent after liver transplantation. Significant progress has been made in the prophylaxis and treatment of recurrent hepatitis B after liver transplantation. This review covers the mechanisms, prophylaxis, and treatment of hepatitis B recurrent after liver transplantation.


METHODS
Searching MEDLINE (1995-2004) for articles on liver transplantation.


RESULTS
HBV reinfection after liver transplantation results from HBV particles in circulation or other extrahepatic sites. Hepatitis B immune globulin (HBIG) was effective in reducing HBV reinfection and improving graft survival after liver transplantation. Lamivudine has also dramatically reduced the recurrence of HBV in the patient undergoing liver transplantation.


CONCLUSIONS
Combination HBIG and lamivudine is the most effective porphylatic regimen. Lamivudine and adefovir are highly effective in treatment of HBV recurrence. HBV-related liver disease is no longer a contraindication for liver transplantation.
Wang
Zi-Fa
ZF
Oriental Organ Transplantation Center, Tianjin First Central Hospital, Tianjin 300191, China. wangzf15213@yahoo.com
Zhu
Zhi-Jun
ZJ
Shen
Zhong-Yang
ZY
D019072:Antibiotic Prophylaxis; D000998:Antiviral Agents / Q000627:therapeutic use*; D006509:Hepatitis B / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use*; D016031:Liver Transplantation; D012008:Recurrence
D000998:Antiviral Agents; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D019259:Lamivudine