Outcome of liver transplantation for hepatitis B: report of a single center's experience.

Abstract

Results of liver transplantation (LT) for hepatitis B have improved significantly with the use of hepatitis B immune globulin (HBIG) and/or lamivudine. The aim of this study is to review the long-term outcome of patients who underwent LT for hepatitis B. Records of 41 patients who underwent LT for hepatitis B and survived 3 months or longer post-LT were reviewed. Twenty patients were administered no immunoprophylaxis or short-term intramuscular HBIG, whereas 21 patients were administered high-dose intravenous (IV) HBIG. Median post-LT follow-up in these 2 groups was 76 months (range, 4 to 155 months) and 25 months (range, 4 to 68 months), respectively. Hepatitis B recurred in 15 (75%) and 4 patients (19%) who underwent LT in the pre-HBIG and post-HBIG eras, respectively. Cumulative rates of recurrent hepatitis B at 1 and 3 years post-LT in these 2 groups were 66% and 77% and 20% and 20%, respectively (P <.001). Recurrent hepatitis B in the post-HBIG era correlated with antibody to hepatitis B surface antigen titer less than 100 IU/L. Nine patients with recurrent hepatitis B were administered lamivudine for 13 to 49 months (median, 28 months); 6 patients continued to have stable or improved liver disease, whereas 3 patients developed virological breakthrough with slow deterioration of liver disease. Long-term IV HBIG is effective in preventing recurrent hepatitis B. The risk for recurrent hepatitis B is negligible after the first year post-LT. Among patients with no virological breakthrough, lamivudine can stabilize or improve liver disease for up to 4 years in patients with recurrent hepatitis B post-LT.

• Authors: C J Chu, R J Fontana, C Moore, D R Armstrong, J D Punch, G L Su, J C Magee, R M Merion, A S Lok
• Journal: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society (Liver Transpl) Vol. 7 Issue 8 Pg. 724-31 (Aug 2001) ISSN: 1527-6465 [Print] United States
• PMID: 11510019 (Publication Type: Journal Article)

Chemical References

• Immunoglobulins
• Reverse Transcriptase Inhibitors
• Lamivudine
• hepatitis B hyperimmune globulin

Topics

• Adult
• Female
• Hepatitis B (drug therapy, surgery)
• Humans
• Immunoglobulins (therapeutic use)
• Lamivudine (therapeutic use)
• Liver Transplantation
• Longitudinal Studies
• Male
• Retrospective Studies
• Reverse Transcriptase Inhibitors (therapeutic use)
• Secondary Prevention
• Treatment Outcome