Role of liver transplantation in viral hepatitis.

Liver transplantation remains difficult in end-stage liver disease caused by chronic viral hepatitis because of recurrent viral infection in the liver graft. After transplantation for chronic hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis delta virus (HDV) disease, recurrence is nearly universal. Patients with actively replicating HBV infection before transplantation appear to be the most likely to experience clinically significant recurrent hepatitis, whereas recurrence in liver transplant patients with HCV and HDV infection before transplantation seems to be less serious in the transplanted liver. At present, hepatitis B Ig immunoprophylaxis can be given to reduce the rate of HBV recurrence in liver graft. However, further studies are needed on ways to prevent and treat viral recurrence in liver transplant patients with viral hepatitis.