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Liver Transpl ; 10(11): 1372-8, 2004 Nov.
Article in English | MEDLINE | ID: mdl-15497163

ABSTRACT

Hepatitis B virus (HBV) recurrence following liver transplantation (LTx) has been controllable primarily with the use of hepatitis B immune globulin (HBIg) and lamivudine (LAM). However, HBV resistance to LAM and/or HBIg has become an increasing problem prompting the use of newer antiviral agents. The purpose of our study was to investigate the association between therapy, HBV breakthrough, and allograft / patient survival in HBV-positive liver transplant recipients. We performed a retrospective review of the medical records of patients that were transplanted for HBV from June 1994 to May 2003. A total of 92 patients, positive for either hepatitis B surface antigen (HBsAg) or HBV deoxyribonucleic acid (DNA) pretransplant, received LAM monotherapy or HBIg (6 months) plus LAM therapy post-liver transplant. HBV breakthrough post-LTx was noted in 14 patients. All patients had detectable HBV DNA prior to liver transplantation; none of the patients that were HBV DNA negative prior to transplant had detectable HBV DNA posttransplant. Of these 14, 9 patients (64%) were switched from LAM to adefovir dipivoxil (ADF) and 5 patients (36%) to tenofovir disoproxil fumarate (TNV). In conclusion, pre-LTx HBV viremia should be considered in planning post-LTx prophylaxis. Trials to evaluate oral antiviral agents in combination with or without HBIg therapy are needed.


Subject(s)
Adenine/analogs & derivatives , Antiviral Agents/pharmacology , Graft Survival/drug effects , Hepatitis B/complications , Liver Failure/surgery , Liver Transplantation , Adenine/pharmacology , Adult , Aged , Drug Resistance, Viral , Female , Humans , Immunoglobulins/pharmacology , Lamivudine/pharmacology , Liver Failure/virology , Male , Middle Aged , Organophosphonates/pharmacology , Recurrence , Retrospective Studies , Survival Analysis , Treatment Outcome
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