title: Prophylaxis against recurrence of HBV hepatitis after living-donor liver transplantation.
abstract: OBJECTIVE
  Although antiviral prophylaxis with the combined high-dose hepatitis B immunoglobulin (HBIg) and lamivudine therapy has effectively reduced post-liver transplantation recurrence of hepatitis B virus infection, its use is limited by cost and availability.
  
  
  METHODS
  Fourteen living-donor liver transplant patients were performed with the mean follow-up of the 23 months (range, 5 to 58 months). We examined the effectiveness of prophylaxis against recurrence of hepatitis B with much lower dose of HBIg. HBIg (10000 IU/day) was two or three times intra- and postoperatively administered and then the serum titers of HBIg was maintained at more than 100 IU/mL.
  
  
  RESULTS
  Although two patients were preoperatively HBV-DNA positive (DNA concentrations were 4.4 and 4.7 LGE, respectively) by a transcription-mediated amplification assay (TMA) method, all 14 patients postoperatively became HBV-DNA-negative and HBsAg-negative.
  
  
  CONCLUSIONS
  Our protocol of the combination low-dose HBIg and lamivudine therapy prevents the recurrence of hepatitis B and is likely to be more cost-effective than high-dose HBIg regimens. Further study is needed to develop the combination therapy of the optimal dose of HBIg and lamivudine.
authors.affiliation: Second Department of Surgery, Faculty of Medicine, Hiroshima University, 1-2-3 Kasumi, Minamik-ku, Hiroshima 734-8551, Japan. htashiro@hiroshima-u.ac.jp
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tashiro
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Itamoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fudaba
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
authors.forename: Saburo
authors.initials: S
authors.lastname: Fukuda
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Kohashi
authors.forename: Hironobu
authors.initials: H
authors.lastname: Amano
authors.forename: Kohei
authors.initials: K
authors.lastname: Ishiyama
authors.forename: Kenntaro
authors.initials: K
authors.lastname: Ide
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ogawa
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shishida
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Irei
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Ushitora
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ohira
authors.forename: Shoichi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Asahara
mesh_terms: D000328:Adult; D000368:Aged; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control*; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention
chemical_list: D004279:DNA, Viral; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin