Long-term prevention of recurrent hepatitis B virus after liver transplantation.

Hepatitis B virus (HBV) reinfection is a major threat to HBV-infected patients undergoing orthotopic liver transplantation. Eleven HBsAg-positive patients with end-stage liver disease underwent liver transplantation. All were treated with high doses of anti-HBs antibodies, initiated first during the anhepatic stage of the operation and continued every 2-8 weeks thereafter according to anti-HBs levels in the serum. Attempts were made to keep anti-HBs levels above 400 IU/ml. Patients were followed for 8-42 months and only one of them had any evidence for recurrence of HBV infection 40 months post-transplantation. We conclude that continuous administration of anti-HBs and maintenance of high levels of anti-HBs in the serum prevent recurrence of HBV infection.