Effect of Dosage and Type of Hepatitis B Immunoglobulin on Hepatitis Antibody Levels in Liver Transplant Recipients.
BACKGROUND
The current study aimed to evaluate the effect of dosage and type (intramuscular [IM] vs intravenous [IV]) of hepatitis B immunoglobulin (HBIG) on hepatitis antibody level in liver transplant recipients.


METHODS
Between September 2000 and August 2016, patients who underwent orthotropic liver transplantation for chronic liver failure or hepatocellular carcinoma secondary to chronic hepatitis B virus (HBV) were retrospectively reviewed from a prospectively maintained database. The analyses of risk factors for postoperative short- and long-term anti-hepatitis B surface antibody levels (as classified level I: 0 to 100 U; II: 100 to 500 U; III: 500 to 1000 U; IV: >1000 U) were performed based on demographic characteristics, hepatitis B envelope antigen, hepatitis B core antibody, HBV DNA, delta antigen, HBIG administration dosage during unhepatic phase (5000 or 10,000 I/U; IM or IV), and type of administration in post-transplant period. Patients who were followed for less than 12 months were excluded from long-term analysis.


RESULTS
The mean follow-up of 58 orthotropic liver transplant patients was 72 (±45) months. No adverse events were observed during both IM and IV type of administration. Compared with IM type, IV administration was associated with a significantly higher HBV antibody level in the short term (for IM and IV: level I: 24% vs 6%; II: 49% vs 18%; III: 12% vs 35%; IV: 15% vs 41%, respectively, P = .007). In the long term, IV administration of hepatitis B immunoglobulin (HBIG) was reported as the sole factor causing higher antibody level (P = .002). Longer follow-up was associated with decreased levels of anti-hepatitis B surface antibody.


CONCLUSIONS
IV HBIG administration in preoperative anhepatic phase and postoperative prophylaxis is associated with higher antibody level both the short and long term without any adverse event.
Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey.
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Ulku
Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey.
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Akcam
Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey. Electronic address: rencuzdr@gmail.com.
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Rencuzogullari
Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey.
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Dalci
Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey.
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Yalav
Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey.
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Eray
Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey.
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Saritas
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000601:surgery / Q000821:virology; D058625:End Stage Liver Disease / Q000601:surgery / Q000821:virology; D005260:Female; D006510:Hepatitis B Antibodies / Q000378:metabolism*; D006515:Hepatitis B virus / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000276:immunology; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage*; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D008113:Liver Neoplasms / Q000601:surgery / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin