title: The role of hepatitis B immunoglobulin in hepatitis B related liver transplantation: Canadian Transplant Centre Position Paper.
abstract: BACKGROUND
  Hepatitis B virus (HBV) related liver transplant (LT) recipients face a high risk of HBV reinfection in the absence of continuous post-operative HBV prophylaxis. Combination HBV prophylaxis with hepatitis B immune globulin (HBIg) and nucleos(t)ide anti-viral agents prevents HBV recurrence in 90 to 100% of patients who undergo transplantation for hepatitis B and is considered the standard of care in Canada. Post liver transplant HBV prophylaxis protocols vary with regard to the dosing, duration and routes of HBIg administration. All Canadian transplant centres managing liver transplant patients were surveyed as to their HBV transplant protocols.
  
  
  RESULTS
  Results of the survey showed that the majority of the Canadian transplant centres use an oral antiviral in combination with long term or indefinite HBIg for prevention of HBV recurrence post liver transplantation. Studies were done to test new protocols using lower HBIg doses given intramuscularly or subcutaneously alone or in combination with antiviral agents. <br /> Conclusion. Long term HBIg administration post transplantation in combination with antiviral agents is an integral part of Canadian HBV related liver transplant protocol. <br />
authors.affiliation: The Multi-Organ Transplant Program, London Health Sciences Centre, London, ON. Mark.Levstik@lhsc.on.ca
authors.forename: Mark
authors.initials: M
authors.lastname: Levstik
authors.forename: Philip
authors.initials: P
authors.lastname: Wong
authors.forename: Erica D
authors.initials: ED
authors.lastname: Greanya
authors.forename: Eric M
authors.initials: EM
authors.lastname: Yoshida
mesh_terms: D000284:Administration, Oral; D000998:Antiviral Agents / Q000008:administration & dosage*; D002170:Canada; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D019538:Health Care Surveys; D006509:Hepatitis B / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage*; D016031:Liver Transplantation / Q000592:standards*; D055502:Secondary Prevention; D059039:Standard of Care; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin