The living donor
liver transplantation (LDLT) experience for patients with hepatitis B virus (HBV)
infection is still limited. Because LDLT can be performed electively, it can provide an appropriate length of time to reduce HBV
DNA levels before the operation. This study aims to examine the feasibility of our protocol for preventing HBV
reinfection after LDLT. Of 20 patients analyzed, 15 patients had detectable serum HBV
DNA when referred to our hospital. Thirteen patients had
hepatocellular carcinoma. All patients were treated with
lamivudine (100 mg/d) before LDLT. After LDLT,
hepatitis B immunoglobulin (
HBIG) was administered to maintain serum antibody to
hepatitis B surface antigen titers at greater than 1,000 IU/mL for 1 year and 200 IU/mL thereafter.
Lamivudine was not administered postoperatively, except for three patients with detectable serum HBV
DNA just before LDLT. All patients survived the operation. One patient died 229 days after LDLT of
carcinoma recurrence. In the other 19 patients, liver function has remained normal and no viral relapse occurred postoperatively during a median follow-up of 19 months. Perioperative use of
lamivudine and indefinite
HBIG administration in the postoperative period might be a rational strategy for preventing HBV
reinfection after LDLT.