Liver transplantation in HBsAg positive graft recipients: Prevention of HBV recurrence by passive immunization

Müller, Ralf; Gubernatis, G.; Farle, H.; Wittekind, Christian; Böker, K.H.W.; Pichlmayr, R.

doi:10.1016/0168-8278(90)91519-3

Cited by 30 publications

(38 citation statements)

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“…Subsequently, the use of high doses of intravenous (IV) hepatitis B immune globulin (HBIG) after OLT reduced HBV recurrence and improved survival. [5][6][7][8][9][10][11][12] Investigators of the European Concerted Action of Viral Hepatitis project 5 reported a 75% rate of HBV recurrence after OLT in patients receiving no prophylaxis or very short-term HBIG treatment and a 33% rate in patients receiving long-term HBIG prophylaxis. The benefit appeared to be greatest among patients with negative HBV DNA and hepatitis Be antigen (HBeAg) before OLT.…”

confidence: 99%

“…13,14 Furthermore, reinfection of the graft by HBV may still occur despite IV HBIG. [5][6][7][8][9][10][11][12] Graft reinfection may be caused by inadequate neutralization because of overwhelming amounts of HBV or break-through infection by escape HBV surface protein mutants. 15,16 Recently, long-term survival and HBV recurrence data using IV HBIG prophylaxis were reported by Samuel et al 17 Excluding patients with delta hepatitis and fulminant liver failure, 89 patients with HBV cirrhosis underwent OLT.…”

confidence: 99%

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Intramuscular hepatitis B immune globulin combined with lamivudine for prophylaxis against hepatitis B recurrence after liver transplantation

et al. 1999

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Immunoprophylaxis using intravenous (IV) hepatitis B immune globulin (HBIG) decreases the recurrence of hepatitis B virus (HBV) infection after orthotopic liver transplantation (OLT). However, IV HBIG is expensive, has significant side effects, and is inconvenient to administer. An alternative approach for prophylaxis using intramuscular (IM) HBIG and oral lamivudine was prospectively evaluated in this study. Ten consecutive patients with cirrhosis with HBV infection who underwent OLT were included in this study. Nine of 10 patients received lamivudine, 150 mg/d, for an average duration of 8.6 months before OLT. Two of 10 patients with detectable HBV DNA at the time of OLT received 10,000 U (45 mL) of IV HBIG daily for 7 consecutive days, followed by 5 mL of IM HBIG weekly for the next 3 weeks, then every 3 weeks. The other 8 patients were HBV DNA negative at OLT and received one dose of IV HBIG (45 mL) during surgery, followed by 5 mL of IM HBIG weekly for 4 weeks, then every 3 weeks. All patients received lamivudine, 150 mg/d, after OLT. During a mean follow-up of 15.6 months, 9 of 10 patients achieved a protective hepatitis B surface antibody (HBsAb) titer greater than 200 IU/L and had no evidence of HBV recurrence. One patient failed to develop an adequate HBsAb titer and developed histological and virological evidence of recurrence. One patient died unrelated to HBV recurrence. Our preliminary data suggest that this combination prophylaxis with IM HBIG and lamivudine is effective and potentially cost saving.

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confidence: 99%

Intramuscular hepatitis B immune globulin combined with lamivudine for prophylaxis against hepatitis B recurrence after liver transplantation

et al. 1999

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“…These individuals have at least a 50% risk of developing hepatitis B in the transplanted liver within 3 years (114). Recurrence can be reduced (up to 50%) with the use of HBIG given either intravenously or intramuscularly starting immediately posttransplantation and continuing indefinitely (64,114,145,146,173). In one retrospective study, the recurrence rate was 74% among 67 patients not given HBIG, 74% among 83 patients given HBIG for 2 months, and 36% among 209 patients given HBIG for 6 months or longer (146).…”

Section: Hepatitis Bmentioning

confidence: 99%

“…An increasingly important use of HBIG is to prevent hepatitis B recurrence in hepatitis B-seropositive liver transplantation recipients, many of whom are transplanted because of complications of hepatitis B infection (64,114,145,173). These individuals have at least a 50% risk of developing hepatitis B in the transplanted liver within 3 years (114).…”

Section: Hepatitis Bmentioning

confidence: 99%

Passive Immunity in Prevention and Treatment of Infectious Diseases

Keller¹,

Stiehm²

2000

Clinical Microbiology Reviews

246

161

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“…5 Trials are underway now to determine whether perioperative treatment with hepatitis B immunoglobulin (HBIG) alters patient outcome and early data are encouraging. 6 However, until more complete results with long-term follow-up are available, this approach remains experimental. Hepatitis C also recurs frequently after liver transplantation.…”

Section: Indications For Liver Transplantationmentioning

confidence: 99%