Abstract
Prophylaxis against hepatitis B virus (HBV) recurrence after orthotopic liver transplantation (OLT) includes lifelong hepatitis B immunoglobulin (HBIG) and oral antiviral agent(s). In the presence of high-genetic-barrier nucleos(t)ide analogues, the need for lifelong HBIG is questioned. We evaluated the safety and cost-effectiveness of a limited HBIG course. OLT from 2006 to 2013 were reviewed. Patients with pre-OLT hepatitis B virus surface antigen who received HBV prophylaxis with 2 HBIG doses (anhepatic and first post-operative day; 10,000 units/dose) and potent nucleos(t)ide analogues were included. The primary end point was HBV recurrence (HBV-DNA detection). Thirteen patients (primary transplants) were included, median Model for End-Stage Liver Disease score was 18, and there was no fulminant failure; HBV-DNA was detected in 4 patients at OLT. After OLT, 10 patients received entecavir and/or tenofovir. Median follow-up was 23 months. One recurrence occurred (7.7%) at month 13 (HBV-DNA: 14 IU/mL); the graft maintained excellent function. This minimal viremic expression is related to hepatocellular carcinoma recurrence with neoplastic replication carrying integrated HBV-DNA; thus, there is no defined HBV viral recurrence. N...Continue Reading
References
Jan 1, 1969·The Journal of Allergy·E F Ellis, C S Henney
Dec 16, 1993·The New England Journal of Medicine·D SamuelH Bismuth
Mar 5, 2003·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·George V PapatheodoridisAndrew K Burroughs
Sep 26, 2003·Clinics in Liver Disease·Mary Ann Huang, Anna S F Lok
Jul 22, 2009·Liver International : Official Journal of the International Association for the Study of the Liver·George V PapatheodoridisAndrew K Burroughs
Nov 13, 2009·Journal of Digestive Diseases·Zhi Feng XiDe Kai Qiu
Mar 30, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·B DegertekinUNKNOWN NIH HBV-OLT Study Group
Feb 9, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·S SaabR W Busuttil
Jun 10, 2011·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Evangelos CholongitasGeore V Papatheodoridis
Oct 1, 2011·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Masatoshi IshigamiHidemi Goto
Oct 11, 2011·Clinical Transplantation·Chang-jie CaiGui-hua Chen
Mar 23, 2012·Journal of Hepatology·UNKNOWN European Association For The Study Of The Liver
May 3, 2012·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Yoshihide UedaShinji Uemoto
May 26, 2012·Transplant Infectious Disease : an Official Journal of the Transplantation Society·E CholongitasE Akriviadis
Jan 1, 2012·Medicare & Medicaid Research Review·Gerald F Riley
Citations
Sep 22, 2015·Viruses·Lei KangJing Tang
Oct 16, 2016·Clinics in Liver Disease·Sammy SaabMyron J Tong
Jun 23, 2020·Minerva medica·Zhiheng Li, Yamei Yang
Mar 4, 2021·Liver International : Official Journal of the International Association for the Study of the Liver·Afroditi OrfanidouEvangelos Cholongitas