RESUMO
Objective@#The aim of this study was to summarize and analyze the clinical features and characteristics of de novo HBV infection after liver transplantation in non-HBV-related liver disease. @*Methods@#We retrospectively analyzed the clinical data of 13 patients with new HBV infection in 376 cases of liver transplantation patients with non-HBV related liver diseases from April 2002 to December 2013 in our hospital. @*Results@#Among 376 patients with non-HBV-related liver disease after liver transplantation, 13 patients developed new HBV infection, and the rate of new HBV infection was 3.46%. Of the 13 cases, 5 were males and 8 were females. The follow-up time was 14.7 -128.7 months, and the average time from surgery to new HBV infection was 19.06 months. The primary diseases were as follows: 5 cases of primary biliary cholangitis, 3 cases of alcoholic liver disease, 2 cases of drug-induced liver damage, 1 cases of post-hepatitis C cirrhosis, congenital biliary atresia and congenital liver fibrosis. All patients were positive for HBsAg, HBeAg, anti-HBc, 11 were positive for HBV DNA, and 2 were negative for HBV DNA. 6 cases had abnormal liver function and 7 cases had normal liver function. All patients were treated with antiviral therapy with nucleoside (acid) analogues. HBsAg was negative in 6 patients; HBsAg remained positive in 7 cases, including HBsAg, HBeAg, anti-HBc positive in 6 cases, HBsAg, anti-HBe, anti- HBc was positive in 1 case, HBV DNA was still positive in 1 patient, and HBV DNA was negative in 6 patients; liver function was normal in all patients. @*Conclusion@#Non-HBV- related liver transplantation are high-risk group of new HBV infection, with the highest incidence of autoimmune liver disease. It is speculated that it may be related to the long-term use of hormones after the transplantation. The prognosis of newly diagnosed HBV infection after liver transplantation is fine as long as it can be found and treated early.
RESUMO
Objective To analyze the HBV recurrence and summarize the experiences in treatment of HBV recurrence after liver transplantation for HBV related liver diseases.Method A total of 650 patients subject to liver transplantation for HBV related liver diseases from September 2002 to February 2007 were included,and the clinical data were retrospectively analyzed.Result Twenty-five (3.85％) of 650 patients experienced HBV recurrence.All liver functions recovered to normal after nucleoside or nucleotide analogs treatment.Two cases lost to follow-up,2 cases were died of tumor recurrence,and 1 case died of tumor recurrence after re-transplantation.Eleven cases were positive for serum HBsAg,and HBV DNA was converted to undetectable levels in 10 cases.One case developed to decompensated liver cirrhosis,and HBsAg was negative after re-transplantation.In 7 cases,after nucleos(t)ide analogs treatment,HBsAg titer was decreased gradually to a lower level,and continuous intravenous drip of large doses of HBIG for 3 to 5 days achieved anti-HBs seroconversion.Conclusion Nucleos(t) ide analogs can effectively suppress viral replication of HBV recurrence after liver transplantation.When the HBsAg titer is decreased to a lower level,large doses of HBIG can achieve anti-HBs seroconversion.