title: Hepatitis B- and hepatitis D-virus-related liver transplant: single-center data.
abstract: OBJECTIVE
  Hepatitis B and D virus coinfection or superinfection lead to chronic liver disease and have poor treatment results and poor prognosis. After transplant, these patients have difficult problems. We aimed to report long-term data of liver transplant recipients who had hepatitis B and D virus-related chronic liver disease.
  
  
  METHODS
  This retrospective, longitudinal study included 25 consecutive hepatitis B surface antigen-positive patients with antihepatitis D virus antibodies. Patient data (age, sex, antiviral treatment, posttransplant use of hepatitis B hyperimmunoglobulin and/or nucleoside/nucleotide analogues, the presence of hepatocellular carcinoma, age at transplant, follow-up) were extracted from patient records.
  
  
  RESULTS
  Females comprised 32% patients. The median age was 44 years (range, 23-63 y). The serum Hepatitis B envelope antigen level was negative in all patients. At the time of transplant, 4 patients were positive for hepatitis B virus DNA and 11 patients also had hepatocellular carcinoma. Posttransplant follow-up was 59 months (range, 3-120 mo). During follow-up, 4 patients died, 4 patients were lost to follow-up, and 17 patients were alive. Posttransplant survival of patients with hepatocellular carcinoma was 50.45 months (range, 3-84 mo) and without hepatocellular carcinoma was 65.8 months (range, 4-120 mo). There were 3 patients who had acute rejection and were treated successfully with pulse doses of prednisolone. Hyperimmunoglobulin therapy was used in conjunction with oral nucleotide/nucleoside analogues for 12 months (range, 3-24 mo) and then stopped. After transplant, 4 patients had antiviral medicine changed to adefovir or entecavir because of drug resistance, and otherwise all patients remained negative for hepatitis B virus DNA during follow-up.
  
  
  CONCLUSIONS
  Patients transplanted for hepatitis B and D virus cirrhosis, even with hepatocellular carcinoma, had favorable prognosis and good longterm results. Close follow-up of patients and effective viral suppression with suitable drugs were key factors for efficient patient care.
authors.affiliation: From the Department of Gastroenterology and Hepatology, Başkent University, Faculty of Medicine, Ankara, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Öcal
authors.forename: Murat
authors.initials: M
authors.lastname: Korkmaz
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Harmancı
authors.forename: Fatih
authors.initials: F
authors.lastname: Ensaroğlu
authors.forename: Aydıncan
authors.initials: A
authors.lastname: Akdur
authors.forename: Haldun
authors.initials: H
authors.lastname: Selçuk
authors.forename: Gökhan
authors.initials: G
authors.lastname: Moray
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D060085:Coinfection; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery* / Q000821:virology; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D019701:Hepatitis D, Chronic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D055815:Young Adult
chemical_list: D000998:Antiviral Agents