Prevention and treatment of hepatitis B relapse after liver transplantation.

OBJECTIVES

To investigate the effect of orthotopic liver transplantation (OLT) on hepatitis B(HB)-related diseases and the efficiency of prevention and treatment with lamivudine on recurrence of hepatitis B posttransplant in China.

METHODS

Orthotopic liver transplantation (OLT) under veno-venous bypass was performed in 10, of whom 9 males had hepatitis B and 1 female had hepatocellular cancer (HCC) without HB pretransplant. Eight of the 9 males had fulminant hepatitis B (FHB) and they all had preoperative serious jaundice, ascites and coagulopathy. Six had encephalopathy; 1 was associated with acute renal failure, and 1 with gastrointestinal hemorrhage. Seven of the 10 patients had lamivudine to prevent reinfection with hepatitis B.

RESULTS

Of the 8 patients who have survived for 2-12 months, 7 have survived for 6-12 months. Two died, one of recurrent FHB and the other from multi-organ failure (MOF). Seven preoprative HB patients of the 8 survivors have excellent liver function through 1 has positive HBsAg 6 months after OLT. One of the 8 survivors, the female with HCC pretransplant, suffered hepatitis B 6 months after OLT and her hepatic function has been gradually improving with lamivudine therapy.

CONCLUSIONS

OLT is an effective therapy for certain cases of FHB and HCC and lamivudine may prevent recurrence of hepatitis B after OLT.