title: Hepatitis B prophylaxis using lamivudine and individualized low-dose hepatitis B immunoglobulin in living donor liver transplantation.
abstract: BACKGROUND
  Currently, most available experience concerning prophylaxis against hepatitis B virus (HBV) recurrence after living donor liver transplantation (LDLT) is limited to studies of small size and short follow-up. The objective of this study was to evaluate the efficacy of a prophylactic regimen using lamivudine and individualized low-dose intramuscular hepatitis B immunoglobulin (HBIG) in LDLT.
  
  
  METHODS
  We used a database of adult-to-adult right-lobe LDLT procedures performed from June 2002 to April 2012 at our center for HBV-related end-stage liver diseases. Patients were divided into 3 groups: group A, HBV-related decompensated liver cirrhosis; group B, fulminant hepatitis B; and group C, hepatocellular carcinoma (HCC).
  
  
  RESULTS
  During a mean follow-up of 38.3 ± 28.9 months, 8 of 165 (4.8%) recipients developed HBV recurrences. The mean time for HBV reinfection was 15.8 + 11.0 months after transplantation. The overall 1-, 3-, and 5-year HBV recurrence rates were 3%, 7%, and 8.2%, respectively. Both patients with fulminant hepatitis B or HCC seemed to have higher rates of HBV recurrence than those with decompensated liver cirrhosis, albeit not significantly. The independent predictor of HBV recurrence was high HBV DNA level (≥10(5) copies/mL) at LDLT.
  
  
  CONCLUSIONS
  Lamivudine and individualized low-dose intramuscular HBIG provides effective prophylaxis against HBV recurrence after LDLT. Pre-LDLT HBV DNA of ≥ 10(5) copies/mL was associated with HBV recurrence.
authors: Liver Transplantation Center, Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
authors: L
authors: L
authors: Jiang
authors: L
authors: L
authors: Yan
authors: T
authors: T
authors: Wen
authors: B
authors: B
authors: Li
authors: J
authors: J
authors: Zhao
authors: J
authors: J
authors: Yang
authors: M
authors: M
authors: Xu
authors: W
authors: W
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000601:surgery / Q000821:virology; D004279:DNA, Viral / Q000097:blood; D004334:Drug Administration Schedule; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000009:adverse effects; D006515:Hepatitis B virus / Q000187:drug effects* / Q000235:genetics / Q000254:growth & development; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage* / Q000009:adverse effects; D007273:Injections, Intramuscular; D019259:Lamivudine / Q000008:administration & dosage* / Q000009:adverse effects; D008103:Liver Cirrhosis / Q000601:surgery / Q000821:virology; D008113:Liver Neoplasms / Q000601:surgery / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055502:Secondary Prevention; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load; D014775:Virus Activation / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D004279:DNA, Viral; D017325:Hepatitis B Vaccines; D007136:Immunoglobulins; D019259:Lamivudine; C045213:hepatitis B hyperimmune globulin