title: Clinicopathological features of hepatitis B virus recurrence after liver transplantation: eleven-year experience.
abstract: OBJECTIVE
  We sought to investigate new changes in the clinical pathology of hepatitis B virus (HBV) recurrence after orthotopic liver transplantation (OLT) in era of new nucleoside or nucleotide analogues.
  
  
  METHODS
  One hundred and eighty-four adult patients who underwent OLT for HBV-related end-stage liver disease between 1999 and 2010 were enrolled in this study. Of these patients, 156 received lamivudine (LAM) plus hepatitis B immune globulin (HBIG) and 28 were treated with LAM. The liver function, serologic parameters and HBV-DNA of the 184 recipients were followed up, and clinical pathological characteristics of grafts with HBV recurrence were examined in this study.
  
  
  RESULTS
  One hundred and seventy-nine (97%) were alive at their last follow-up and eleven (6%) had developed HBV recurrence at a median of 22 (range 6 to 46) months post-OLT. Two of the 11 recipients were detected with HBV-S gene mutation, and 5 were tested with YMDD mutation. Four recipients who died of irreversible graft dysfunction secondary to HBV recurrence, developed fibrosing cholestatic hepatitis (FCH) because of no effective antiviral agents available in the early stages of HBV recurrence after OLT. Six recipients who received adefovir (ADV) (and Entecavir, ETV) in the early stages of HBV recurrence after OLT achieved improvement in hepatic histology.
  
  
  CONCLUSIONS
  HBV recurrence post-OLT could be controlled at an acceptable level for a long time and the recipients could achieve long-term survival by using new antiviral agents, instead of advancing into FCH in the short term after HBV recurrence.
authors.affiliation: Department of General Surgery, Lanzhou University Second Hospital Lanzhou 730030, China.
authors.forename: Donghong
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Lanzhou University Second Hospital Lanzhou 730030, China.
authors.forename: Zuoyi
authors.initials: Z
authors.lastname: Jiao
authors.affiliation: Department of General Surgery, Lanzhou University Second Hospital Lanzhou 730030, China.
authors.forename: Jixiang
authors.initials: J
authors.lastname: Han
authors.affiliation: Department of General Surgery, Lanzhou University Second Hospital Lanzhou 730030, China.
authors.forename: Hongtai
authors.initials: H
authors.lastname: Cao
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012008:Recurrence
chemical_list: D000998:Antiviral Agents; D007136:Immunoglobulins; D019259:Lamivudine; C045213:hepatitis B hyperimmune globulin
keywords: Lamivudine; fibrosing cholestatic hepatitis; hepatitis B immunoglobulin; hepatitis B virus; liver transplantation; recurrence