title: Prevention of hepatitis B virus recurrence after liver transplantation.
abstract: Liver transplantation for hepatitis B virus (HBV)-related liver disease has changed from a contraindication to outcomes comparable with non-HBV-related liver transplantations during the last two decades. Mainly the implementation of immunoprophylaxis with hepatitis B immunoglobulin (HBIG) and the use of nucleoside analogs such as lamivudine and adefovir account for this dramatic change. The standard of care in most centers today consists of lamivudine treatment in replicating hepatitis B pre-orthotopic liver transplantation (OLT) and a combination regimen of lamivudine and HBIG post-OLT. With adefovir, a potent antiviral drug became available in recent years that allows for the treatment of patients with lamivudine-resistant tyrosine-methionine-aspartate-aspartate (YMDD)-mutant HBV. In the transplantation setting, first studies indicate that a triple prophylactic therapy consisting of lamivudine, adefovir, and HBIG will become the standard of care for YMDD-mutant-related hepatitis B. With new drugs emerging for the treatment of chronic HBV, there is optimism for new options also in the transplant setting.
authors.affiliation: Department of Internal Medicine IV, University of Heidelberg, Heidelberg, Germany. christoph_eisenbach@med.uni-heidelberg.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Eisenbach
authors.forename: Peter
authors.initials: P
authors.lastname: Sauer
authors.forename: Arianeb
authors.initials: A
authors.lastname: Mehrabi
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Stremmel
authors.forename: Jens
authors.initials: J
authors.lastname: Encke
mesh_terms: D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000517:prevention & control* / Q000601:surgery; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D016031:Liver Transplantation; D011183:Postoperative Complications; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D055502:Secondary Prevention
chemical_list: D007136:Immunoglobulins; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine