Protocol liver biopsies in long-term management of patients transplanted for hepatitis B-related liver disease.

Abstract

AIM:

To evaluate the long-term histological outcome of patients transplanted for HBV-related liver disease and given HBIg prophylaxis indefinitely after LT.

METHODS:

Forty-two consecutive patients transplanted for hepatitis B were prospectively studied. HBsAg, HBV-DNA and liver function tests were evaluated in the serum 3, 6 and 12 mo after LT and then yearly. LB was obtained 6 and 12 mo after LT and yearly thereafter. Chronic hepatitis (CH) B after LT was classified as minimal, mild, moderate or severe.

RESULTS:

HBV recurred in 7/42 (16.6%) patients after 6-96 mo of follow-up. A hundred and eighty-seven LB were evaluated. Four of 7 patients with graft reinfection, all with unknown HBV DNA status before LT, developed cirrhosis at 12-36 mo of follow-up. Of the 122 LB obtained from 28 HBsAg+/HCV- recipients with no HBV recurrence after LT, all biopsies were completely normal in only 2 patients (7.1%), minimal/non-specific changes were observed in 18 (64.2%), and at least 1 biopsy showed CH in the remaining 8 (28.5%). Twenty-nine LB obtained from 7 patients transplanted for HBV-HCV cirrhosis and remaining HBsAg- after LT revealed recurrent CH-C. Actuarial survival was similar in patients with HBsAg+ or HBsAg- liver diseases.

CONCLUSION:

Though protocol biopsies may enable the detection of graft dysfunction at an early stage, the risk of progression and the clinical significance of these findings remains to be determined.

• Authors: Stefano Targhetta, Federico Villamil, Paolo Inturri, Patrizia Pontisso, Stefano Fagiuoli, Umberto Cillo, Attilio Cecchetto, Simona Gianni, Remo Naccarato, Patrizia Burra
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 12 Issue 11 Pg. 1706-12 (Mar 21 2006) ISSN: 1007-9327 [Print] United States
• PMID: 16586538 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• DNA, Viral
• Hepatitis B Surface Antigens
• Immunoglobulins
• hepatitis B hyperimmune globulin

Topics

• Biopsy, Needle (methods)
• Clinical Protocols
• DNA, Viral (blood)
• Follow-Up Studies
• Hepatitis B (diagnosis, surgery)
• Hepatitis B Surface Antigens (blood)
• Hepatitis B virus (genetics)
• Humans
• Immunoglobulins (therapeutic use)
• Liver (pathology)
• Liver Cirrhosis (diagnosis)
• Liver Function Tests
• Liver Transplantation (pathology)
• Prospective Studies
• Recurrence
• Time Factors
• Treatment Outcome