Prevention and treatment of hepatitis B relapse after liver transplantation

investigate the effect of orthotopic liver transplantation (OLT) on hepatitis B(HB) related diseases and the efficiency of prevention and treatment with lamivudine on recurrence of hepatitis B posttransplant in China Methods Orthotopic liver transplantation (OLT) under veno venous bypass was performed in 10, of whom 9 males had hepatitis B and 1 female had hepatocellular cancer (HCC) without HB pretransplant Eight of the 9 males had fulminant hepatitis B (FHB) and they all had preoperative serious jaundice, ascites and coagulopathy. Six had encephalopathy; 1 was associaled with acute renal failure, and 1 with gastro intestinal hemorrhage Seven of the 10 patients had lamivudine to prevent reinfection with hepatitis B Results Of the 8 patients who have survived for 2-12 months, 7 have survived for 6-12 months. Two died, one of recurrent FHB and the other from multi organ failure (MOF) Seven preoperative HB patients of the 8 survivors have excellent liver function though 1 has positive HBsAg 6 months after OLT One of the 8 survivors, the female with HCC pretransplant, suffered hepatitis B 6 months after OLT and her hepatic function has been gradually improving with lamivudine therapy Conclusions OLT is an effective therapy for certain cases of FHB and HCC and lamivudine may prevent recurrence of hepatitis B after OLT