Liver transplantation for hepatitis B virus patients: long-term results of three therapeutic approaches.
The indications for liver transplantation among patients with post-hepatitis B virus (HBV)-related cirrhosis have changed over the past 35 years. We reviewed the long-term results of 47 patients treated with liver transplantation for HBV-related cirrhosis. Patients were classified into 3 groups according to the perioperative regimen. In the initial experience, no immunoprophylaxis was adopted (no-IP; n=5). From 1988-1996, an immunoprophylaxis scheme was adopted (HBIg; n=16). From 1997-2007, we adopted the combination of lamivudine and HBIg (LAM-HBIg; n=26). We calculated the prevalence of serological reinfection and patient survival at 1 to 20 years, using the 3 regimens. The recurrence rate was 75% in the group of untreated patients; 30% in the HBIg group; and 9% in the LAM-HBIg group. The overall survival was 67% at 5 years, and 64% at 10 and 20 years. The long-term survival for each of the 3 therapeutic approaches, namely, for the patients who did not receive any treatment, for the HBIg group, and for the LAM-HBIg group, were 20%, 50%, and 84%, respectively. We suggest to use the LAM-HBIg combination.
Avolio
A W
AW
Department of Surgery-Transplantation Service, Catholic University-A. Gemelli Hospital, Rome, Italy. alfonso.alvolio@rm.unicatt.it
Nure
E
E
Pompili
M
M
Barbarino
R
R
Basso
M
M
Caccamo
L
L
Magalini
S
S
Agnes
S
S
Castagneto
M
M
D000328:Adult; D000368:Aged; D006509:Hepatitis B / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000627:therapeutic use; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology*; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin