Emerging trends in transplantationLiver transplantationHepatitis B Prophylaxis Using Lamivudine and Individualized Low-dose Hepatitis B Immunoglobulin in Living Donor Liver Transplantation
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Patients
We used a database of adult-to-adult right-lobe LDLT procedures performed at our center from June 2002 to April 2012 for HBV-related ESLDs, including decompensated liver cirrhosis, fulminant hepatitis B, and HCC, for this analysis. Enrolled patients had no evidence of coinfection with hepatitis C, hepatitis D, or human immunodeficiency virus. Finally, a total of 165 adult patients were enrolled in this study. The patients were monitored until July 2012 or their death, and their medical records
Characteristics of Recipients and Their Donors
Table 1 summarizes the recipients' data at the time of transplantation. Patients in group C were older than those in groups A and B, whereas patients in group B had the highest mean model for end-stage liver disease score, followed by groups A and C. Among the patients with HCC, 41 (43.6%) had tumors within the Milan criteria, 59 (62.8%) had tumors within the University of California, San Francisco (UCSF) criteria, and 35 (37.2%) had tumors exceeding the UCSF criteria. Other data shown in the
Discussion
To date, most available studies concerning prophylaxis against HBV recurrence after LDLT are limited, of small size, and have a short follow-up time.3 To the best of our knowledge, one representative research with the largest sample size and longest follow-up time was from Hwang et al,4 in which the high-dose HBIG monotherapy resulted in a 10-year HBV recurrence rate of 7.3%. However, this protocol could not be replicated in mainland China because of the unavailability of intravascular HBIG and
References (11)
- et al.
Prophylaxis against hepatitis B recurrence posttransplantation using lamivudine and individualized low-dose hepatitis B immunoglobulin
Am J Transplant
(2010) - et al.
Hepatocellular carcinoma is associated with an increased risk of hepatitis B virus recurrence after liver transplantation
Gastroenterology
(2008) - et al.
Increasing applicability of liver transplantation for patients with hepatitis B-related liver disease
Hepatology
(2002) - et al.
Prophylactic strategies for hepatitis B patients undergoing liver transplant: a cost-effectiveness analysis
Liver Transpl
(2006) - et al.
Hepatitis B prophylaxis in living donor liver transplantation: single center experience
Hepatogastroenterology
(2010)
Cited by (11)
Asociación Mexicana de Hepatología A.C. Clinical guideline on hepatitis B
2021, Revista de Gastroenterologia de MexicoAntiviral Combination Therapy with Low-Dose Hepatitis B Immunoglobulin for the Prevention of Hepatitis B Virus Recurrence in Liver Transplant Recipients: A Single-Center Experience
2015, Transplantation ProceedingsCitation Excerpt :In the light of these limitations, decreasing the dose of HBIG as prophylaxis has been of particular interest. Early studies have reported similar results compared with that of previous dosages [10–12]. HBIG in combination with antivirals such as lamivudine as a therapeutic protocol has not been well embraced because of lamivudine-related resistance.
Antiviral prophylaxis against hepatitis B recurrence after liver transplantation: Current concepts
2021, Liver InternationalSafety of hepatitis B virus core antibody-positive grafts in liver transplantation: A single-center experience in China
2018, World Journal of GastroenterologyCurrent clinical evidence for nucleos(T)ide analogues in patients with HBV-related hepatocellular carcinoma
2017, Expert Review of Gastroenterology and HepatologyA new scheme with infusion of hepatitis B immunoglobulin combined with entecavir for prophylaxis of hepatitis B virus recurrence among liver transplant recipients
2015, European Journal of Gastroenterology and Hepatology
Supported by a grant from the National Natural Science Foundation of China (81170456).