Prevention of hepatitis B virus reinfection after orthotopic liver transplantation.

BACKGROUND

Hepatitis B virus reinfection is an important problem after liver transplantation. The aim of this study was to discuss the prevention of hepatitis B virus reinfection following orthotopic liver transplantation.

METHODS

Sixty-eight cases of chronic fulminant hepatitis B, end-stage liver cirrhosis, and liver carcinoma complicated with HBV cirrhosis were given anti-viral drugs before and after transplantation to prevent hepatitis B virus reinfection. Lamivudine was administered in 2 patients, lamivudine+hepatitis B immunoglobulin (HBIG) in 63, and adefovir+HBIG in 3. The measurement of serum HBV, HBV DNA, liver biopsy immunohistochemistry and clinical study were performed.

RESULTS

In 1 of the 2 patients who developed reinfection after lamivudine administration, serum HBsAg, HBeAb, HBcAb, HBV DNA were positive and liver biopsy immunohistochemistry showed HBsAg phenotype. In 2 of 63 patients who developed reinfection after use of lamivudine+HBIG, serum HBsAg, HBeAb, HBcAb were positive and liver biopsy immunohistochemistry showed HBsAg phenotype. Serum HBV DNA was positive in one of them. Three patients developed no reinfection with HBV after use of adefovir.

CONCLUSIONS

Orthotopic liver transplantation is effective in the treatment of HBV-infected diseases. Lamivudine+HBIG or adefovir+HBIG could effectively prevent hepatitis B virus reinfection.