Hepatit B virus enfeksiyonu nedenli karaciğer nakillerde son yıllardaki değişim

Abstract

In the last decade, both hepatitis B virus (HBV) prevalence and mortality related to HBV infection have decreased promptly. Worldwide HBV vaccination programs, precautions against HBV transmission and effective anti-viral drugs on market play crucial role for this encouraging result. Besides stopping or reversing the hepato-fibrogenesis induced by HBV infection, fighting against HBV related acute severe hepatitis are also improved recently. HBV associated cirrhosis is still the major cause of LTx, particularly in developing countries,whereas in developed countries, the rate of LTx due to HBV induced cirrhosis has declined over time. With the expanding use of NUCs before LTx, and the use of NUCs and HBIg even after LTx, HBV recurrence after LTx is no longer an important reason for graft loss or patient death. However, this positive impact is not yet reflecting survival, probably because of increasing recipient and donor ages. On the other hand, in the era of Milan criteria, overall hepatocellular carcinoma (HCC) survival has so increased that the number of transplanted HCC cases has almost doubled. However tumor recurrence is still the major cause of death, and treatment is still problematic.