title: Long-term results of hepatitis B immunoglobulin and lamuvidine for hepatitis B prophylaxis after liver transplantation.
abstract: OBJECTIVE
  Recurrence of hepatitis B virus after a liver transplantation (OLT) is a risk factor affecting graft and patient survivals. Short-term hepatitis B virus reactivation rates after OLT range between 3% and 15%. Using combination prophylaxis, the outcomes of OLT among patients with liver disease related to hepatitis B virus have improved to levels comparable to those whose disease is not related to hepatitis B virus.
  
  
  METHODS
  Since September 2001, we performed 288 OLT in 282 patients including 74 who had liver failure related to hepatitis B virus among whom 58 were followed for >12 months and analyzed retrospectively. Our protocol included lamivudine (100 mg orally per day beginning the day after surgery) and hepatitis B immunoglobulin (10,000 IU IV during the anhepatic phase, 2000 IU/d IV during the first week after surgery, 2000 IU IV/month from postoperative months 1 to 12). Using our protocol, the anti-hepatitis B surface antibodies (HBsAb) serum titer was maintained up to 100 IU/mL. The female:male ratio was 11:47. The mean age of patients was 43±12.8 years.
  
  
  RESULTS
  Five patients died of causes unrelated to hepatitis B virus. At the time of death, their hepatitis B surface antigens were negative, and serum titers of anti-HBsAb were 45, 35.3, 56.4, 79.6, and 123 IU/mL. Mean follow-up was 46.5±18.9 months (range, 12-79). The hepatitis B surface antigen became positive in 4 patients; the remaining 49 had no evidence of hepatitis B surface antigen. In 18 patients, serum titer of anti-hepatitis B surface antigen was 0; in the remaining 31 patients, it was 69.2±133 IU/mL.
  
  
  CONCLUSIONS
  Our combination protocol with hepatitis B immunoglobulin and lamivudine is a safe, cost-saving, and effective treatment for hepatitis B virus prophylaxis after liver transplantation.
authors: Department of General Surgery, Başkent University Faculty of Medicine, Ankara, Turkey.
authors: S
authors: S
authors: Sevmis
authors: S
authors: S
authors: Aktas
authors: H H
authors: HH
authors: Zia
authors: A
authors: A
authors: Atiq
authors: E
authors: E
authors: Akbas
authors: H
authors: H
authors: Selcuk
authors: H
authors: H
authors: Karakayali
authors: M
authors: M
authors: Haberal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006509:Hepatitis B / Q000097:blood* / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000737:chemistry; D006801:Humans; D007136:Immunoglobulins / Q000276:immunology*; D019259:Lamivudine / Q000494:pharmacology*; D017093:Liver Failure / Q000150:complications; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology; D012307:Risk Factors
chemical_list: D006514:Hepatitis B Surface Antigens; D007136:Immunoglobulins; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine