Intramuscular hepatitis B immune globulin combined with lamivudine in prevention of hepatitis B recurrence after liver transplantation.
BACKGROUND
Combined hepatitis B immune globulin (HBIg) and lamivudine in prophylaxis of the recurrence of hepatitis B after liver transplantation has significantly improved the survival of HBsAg positive patients. This study was undertaken to evaluate the outcomes of liver transplantation for patients with hepatitis B virus (HBV).


METHODS
A retrospective chart analysis and a review of the organ transplant database identified 51 patients (43 men and 8 women) transplanted for benign HBV-related cirrhotic diseases between June 2002 and December 2004 who had survived more than 3 months. HBIg was administered intravenously during the first week and intramuscularly thereafter.


RESULTS
At a median follow-up of 14.1 months, the overall recurrence rate in the 51 patients was 3.9% (2/51). The overall patient survival was 88.3%, and 82.4% after 1 and 2 years, respectively. A daily oral dose of 100 mg lamivudine for 2 weeks before transplantation for 10 patients enabled 57.1% (4/7) and 62.5% (5/8) of HBV-DNA and HBeAg positive patients respectively to convert to be negative. Intramuscular HBIg was well tolerated in all patients.


CONCLUSIONS
Lamivudine combined with intramuscular HBIg can effectively prevent allograft from the recurrence of HBV after liver transplantation.
Yan
Mao-Lin
ML
Liver Transplantation Group of Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, China.
Yan
Lu-Nan
LN
Li
Bo
B
Zeng
Yong
Y
Wen
Tian-Fu
TF
Wang
Wen-Tao
WT
Yang
Jia-Yin
JY
Xu
Ming-Qing
MQ
Li
Zhi-Hui
ZH
Chen
Yong-Bing
YB
D000998:Antiviral Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control*; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage*; D007273:Injections, Intramuscular; D019259:Lamivudine / Q000008:administration & dosage*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D015996:Survival Rate
D000998:Antiviral Agents; D007136:Immunoglobulins; D019259:Lamivudine; C045213:hepatitis B hyperimmune globulin