Liver transplantation for hepatitis B-related cirrhosis: recent advances |
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Authors: | Sugawara Yasuhiko Makuuchi Masatoshi |
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Institution: | (1) Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan |
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Abstract: | In the absence of preventative therapy, deceased-donor liver transplantation indicated for hepatitis B virus (HBV) cirrhosis
results in dismal graft and patient survival due to HBV infection of the liver graft. Major advances in the management of
HBV-infected recipients during the past 15 years have reduced the rate of graft infection, resulting in improved outcomes,
comparable to those for patients transplanted for non-HBV indications. Long-term use of hepatitis B immunoglobulin for passive
immunotherapy is effective in preventing re-infection. Combination therapy with hepatitis B immunoglobulin and lamivudine
after liver transplantation reduces HBV recurrence. Adefovir dipoxil is a safe and effective alternative oral antiviral treatment
for lamivudine-resistant mutant HBV. The high cost of hepatitis B immunoglobulin remains a problem that must be overcome by
the development of HBV vaccines and potent adjuvants. |
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Keywords: | Hepatitis B virus Living-donor liver transplantation Lamivudine |
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