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LIVER TRANSPLANTATION IN HEPATITIS B VIRAL INFECTION

TAJANA FILIPEC KANIŽAJ ; Merkur University Hospital, University of Zagreb, School of Medicine, Clinical Department of Internal Medicine, Zagreb, Croatia
VESNA ČOLIĆ-CVRLJE ; Merkur University Hospital, University of Zagreb, School of Medicine, Clinical Department of Internal Medicine, Zagreb, Croatia
ANNA MRZLJAK ; Merkur University Hospital, University of Zagreb, School of Medicine, Clinical Department of Internal Medicine, Zagreb, Croatia
RAJKO OSTOJIĆ ; Zagreb University Hospital Center, School of Medicine, University of Zagreb, Clinical Department of Internal Medicine, Department of Gastroenterology, Zagreb, Croatia

Abstract

Hepatitis B infection (HBV) causes liver cirrhosis and hepatocellular carcinoma that are indications for orthotopic liver transplantation (OLT). The outcome of OLT depends on the prevention of HBV reinfection and disease relapses. Out of 692 liver transplantations performed at Merkur University Hospital, 30 were done for HBV infection. These patients were treated with HBIG post OLT and lamivudine, entecavir, adefovir, tenofovir prior and post OLT. All patients became HBsAg and HBV DNA negative but four of them became HbsAg positive one year post OLT. The patients survived for 2 months to 7 years post OLT. With the introduction of HBIG immunoprophylaxis and new efficient antiviral treatment, the risk of relapse is only <10%, and survival is the same as in other indications for OLT. Because of the high cost and long-term treatment, efforts have been made to prevent recurrent HBV disease by using the schedules according to pre- and post-transplant HBV viremia and introducing the new potent antiviral analogue nucleos(t)ides.

Keywords

liver transplantation; HBV immunoprophylaxis; hepatitis B immunoglobulin; nucleos(t)ide analogues

Hrčak ID:

113725

URI

https://hrcak.srce.hr/113725

Publication date:

14.1.2014.

Article data in other languages: croatian

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