title: [Clinical pathology of recurrent hepatitis B after liver transplantation].
abstract: OBJECTIVE
  To investigate the clinical pathology of recurrent hepatitis B after orthotopic liver transplantation (OLT).
  
  
  METHODS
  The clinical manifestation and hepatic pathological characteristics of 12 patients with recurrent hepatitis B after OLT were examined in this study by using hematoxylin and eosin staining,immunochemical staining of hepatitis B surface antigen and hepatitis B core antigen,tissue in situ hybridization of hepatitis B virus (HBV) DNA, and Mallory's trichrome staining.The survival rate of these OLT patients was assessed by Kaplan-Meier analysis.
  
  
  RESULTS
  The early stage of recurrent HBV infection in patients with OLT was characterized by active HBV replication and mild-to-moderate inflammation in the liver. Three of the 12 patients who were treated with combination therapy group were carriers of YMDD mutants and all three showed improvement in liver function and hepatic histology after receiving adefovir dipivoxil,instead of lamivudine,in the early stage of recurrent hepatitis B after OLT. Among the patients treated with lamivudine monotherapy, four did not achieve improvement at the early stage of recurrent hepatitis B and developed fibrosing cholestatic hepatitis (FCH).
  
  
  CONCLUSIONS
  Recurrent hepatitis B in patients who underwent OLT was characterized by mild-to-moderate viral hepatitis at the early stage and FCH at the later stage. Effective antiviral intervention at the early stage may reverse recurrent hepatitis B and prevent the disease progression to fatal FCH.
authors.affiliation: General Surgery Department One, Second Hospital of Lanzhou University, Key Laboraory of Digestive System Tumors of Gansu Province, Lanzhou 730030, China.
authors.forename: Zuoyi
authors.initials: Z
authors.lastname: Jiao
authors.forename: Donghong
authors.initials: D
authors.lastname: Zhang
authors.forename: Lunan
authors.initials: L
authors.lastname: Yan
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives; D000998:Antiviral Agents; D006509:Hepatitis B / Q000473:pathology*; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D006515:Hepatitis B virus; D006801:Humans; D019259:Lamivudine; D016031:Liver Transplantation; D063065:Organophosphonates; D012008:Recurrence
chemical_list: D000998:Antiviral Agents; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D063065:Organophosphonates; D019259:Lamivudine; D000225:Adenine; C106812:adefovir dipivoxil