Prophylaxis against recurrence of HBV hepatitis after living-donor liver transplantation.
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.
Tashiro
Hirotaka
H
Second Department of Surgery, Faculty of Medicine, Hiroshima University, 1-2-3 Kasumi, Minamik-ku, Hiroshima 734-8551, Japan. htashiro@hiroshima-u.ac.jp
Itamoto
Toshiyuki
T
Fudaba
Yasuhiro
Y
Ohdan
Hideki
H
Fukuda
Saburo
S
Kohashi
Toshihiko
T
Amano
Hironobu
H
Ishiyama
Kohei
K
Ide
Kenntaro
K
Ogawa
Takayuki
T
Shishida
Masayuki
M
Irei
Toshimitsu
T
Ushitora
Yuichiro
Y
Ohira
Masahiro
M
Takahashi
Shoichi
S
Chayama
Kazuaki
K
Asahara
Toshimasa
T
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
D004279:DNA, Viral; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin