Preoperative Antiviral Treatment and Postoperative Prophylaxis in HBV-Dna Positive Patients Undergoing Liver Transplantation

Seehofer, Daniel; Rayes, Nada; Naumann, U; Neuhaus, R.; Müller, A.R; Tullius, Stefan G.; Berg, Thomas; Steinmüller, Thomas; Bechstein, Wolf O.; Neuhaus, P.

doi:10.1097/00007890-200110270-00008

Cited by 72 publications

(65 citation statements)

References 17 publications

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“…A number of reports [18][19][20] have been published in this field. However, all studies were performed after DLT.…”

Section: Discussionmentioning

confidence: 99%

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Living donor liver transplantation for hepatitis B cirrhosis

Sugawara¹,

Makuuchi²,

Kaneko³

et al. 2003

Liver Transplantation

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The living donor liver transplantation (LDLT) experience for patients with hepatitis B virus (HBV) infection is still limited. Because LDLT can be performed electively, it can provide an appropriate length of time to reduce HBV DNA levels before the operation. This study aims to examine the feasibility of our protocol for preventing HBV reinfection after LDLT. Of 20 patients analyzed, 15 patients had detectable serum HBV DNA when referred to our hospital. Thirteen patients had hepatocellular carcinoma. All patients were treated with lamivudine (100 mg/d) before LDLT. After LDLT, hepatitis B immunoglobulin (HBIG) was administered to maintain serum antibody to hepatitis B surface antigen titers at greater than 1,000 IU/mL for 1 year and 200 IU/mL thereafter. Lamivudine was not administered postoperatively, except for three patients with detectable serum HBV DNA just before LDLT. All patients survived the operation. One patient died 229 days after LDLT of carcinoma recurrence. In the other 19 patients, liver function has remained normal and no viral relapse occurred postoperatively during a median follow-up of 19 months. Perioperative use of lamivudine and indefinite HBIG administration in the postoperative period might be a rational strategy for preventing HBV reinfection after LDLT.

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“…A number of reports [18][19][20] have been published in this field. However, all studies were performed after DLT.…”

Section: Discussionmentioning

confidence: 99%

“…Of 166 cadaveric liver transplant recipients, only 42 patients (25%) were administered preoperative lamivudine, and duration of treatment was not described. Seehofer et al 19 reported 74 preoperatively HBV DNA-positive patients who underwent DLT. Of these, 17 patients were treated preoperatively with lamivudine.…”

Section: Discussionmentioning

confidence: 99%

Living donor liver transplantation for hepatitis B cirrhosis

Sugawara¹,

Makuuchi²,

Kaneko³

et al. 2003

Liver Transplantation

View full text Add to dashboard Cite

show abstract

“…Numerous studies reported since 1996 have shown that pre-OLT administration of LAM for at least 4 weeks resulted in eradication of serum HBV DNA in 62.5% to 100% of treated patients. [44][45][46][47][48][49][50][51][52] This has been a major achievement considering that the status of HBV replication at the time of OLT is the major determinant of risk for recurrence. On a practical basis, it can be stated that with the advent of LAM, the majority of patients can now be allocated to two categories at the time of OLT: spontaneously or LAM-induced HBV DNA negative.…”

Section: Lamivudine Therapy Before Oltmentioning

confidence: 99%

“…48,[50][51][52][53] Patients who develop LAM resistance before OLT may be at increased risk for graft reinfection caused by reappearance of HBV replication and also because mutations in the polymerase gene may affect the amino acid sequence of the envelope protein, rendering HBIg less effective, as suggested by Locarnini et al 54 in 1998. Consequently, the optimal timing to initiate LAM treatment before OLT remains unclear.…”

Section: Lamivudine Therapy Before Oltmentioning

confidence: 99%