title: Living donor liver transplantation for hepatitis B cirrhosis.
abstract: OBJECTIVE
  Living donor liver transplantation (LDLT) has particular advantages for Turkey where hepatitis B virus (HBV) infection is the most common cause of cirrhosis, both because LDLT circumvents the difficulties encountered in the emerging world in providing deceased donor organs, and because it allows preemptive antiviral therapy. The aim of this study was to review one institution's experience with LDLT in patients with chronic HBV infection.
  
  
  METHODS
  A total of 109 patients with chronic HBV infection underwent LDLT between September 1999 and June 2005, of whom 40 were coinfected with hepatitis D virus and 23 had hepatocellular carcinoma. Antiviral prophylaxis was attempted in all, beginning prior to transplantation with lamivudine or adefovir, and continuing after transplantation with low dose intramuscular hyperimmune B immunoglobulin (HBIg) plus lamivudine or adefovir.
  
  
  RESULTS
  In a median follow up of 20 months (range 1-66 months), there was no donor mortality. One-year recipient survival was 90%, and in total 16 recipients died. None of the deaths was related to HBV. Recurrence of HBV infection was detected by reappearance of serum hepatitis B surface antigen in six patients (5.5%) at 5, 8, 12, 17, 34 and 46 months after transplantation, respectively. There was no influence of donor hepatitis B core antibody status on the likelihood of recurrence of HBV in the allograft.
  
  
  CONCLUSIONS
  The results indicate that LDLT with antiviral treatment and low dose HBIg provides excellent results for donors and recipients.
authors.affiliation: Department of Gastroenterology, Ege University Medical School, Bornova, Izmir, Turkey.
authors.forename: Zeki
authors.initials: Z
authors.lastname: Karasu
authors.forename: Murat
authors.initials: M
authors.lastname: Akyildiz
authors.forename: Murat
authors.initials: M
authors.lastname: Kilic
authors.forename: Murat
authors.initials: M
authors.lastname: Zeytunlu
authors.forename: Unal
authors.initials: U
authors.lastname: Aydin
authors.forename: Fatih
authors.initials: F
authors.lastname: Tekin
authors.forename: Funda
authors.initials: F
authors.lastname: Yilmaz
authors.forename: Tijen
authors.initials: T
authors.lastname: Ozacar
authors.forename: Ulus
authors.initials: U
authors.lastname: Akarca
authors.forename: Galip
authors.initials: G
authors.lastname: Ersoz
authors.forename: Fulya
authors.initials: F
authors.lastname: Gunsar
authors.forename: Tankut
authors.initials: T
authors.lastname: Ilter
authors.forename: Michael R
authors.initials: MR
authors.lastname: Lucey
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000150:complications* / Q000628:therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012698:Serologic Tests