title: Living donor liver transplantation for hepatitis B associated liver diseases: a 10-year experience in a single center.
abstract: OBJECTIVE
  Hepatic failure associated with hepatitis B virus (HBV) is one of the main indications for living donor liver transplantation (LDLT).
  
  
  METHODS
  Twenty-nine LDLTs, including liver cirrhosis due to HBV (LC-B) (n = 17) and fulminant hepatitis B (FH-B) (n = 12) were reviewed. Prophylaxis for reinfection was performed with a combination of lamivudine, or hepatitis B immune globulin (HBIG) or adefovir, depending on the viral status. The changes in serological markers, recurrence and survival rate were examined.
  
  
  RESULTS
  There were 3 patients with re-emergencies of HBV surface antigen (HBsAg): suspension of HBIG for giving vaccination for HBV (n = 1), HBsAg positive donor (n = 1) and non-compliance for HBIG (n = 1). All patients with YMDD mutants (n = 9), except the case with HBsAg positive donor (n = 1), were successfully protected by the triple therapy of lamivudine, adefovir and HBIG. No graft loss was due to the recurrence of HBV.
  
  
  CONCLUSIONS
  The basic strategy using a combination of HBIG and antiviral agents gave acceptable long-term outcomes for LDLT for HBV associated liver diseases. The close monitoring of HBV viral status after transplantation is still crucial in managing these patients.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. tikesurg@yahoo.co.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Ikegami
authors.forename: Yuji
authors.initials: Y
authors.lastname: Soejima
authors.forename: Ryuji
authors.initials: R
authors.lastname: Ohta
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yoshizumi
authors.forename: Noboru
authors.initials: N
authors.lastname: Harada
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kayashima
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D017093:Liver Failure / Q000401:mortality / Q000601:surgery* / Q000821:virology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents