Prevention And Treatment Of Hepatitis B Virus Recurrence After Liver Transplantation

Objective To explore the curative effect of Lamivudine combined with low-dosage hepatitis B immunoglobulin to prevent recurrence of hepatitis B virus (HBV) after liver transplantation. Methods fifty submitted to liver transplantation used Lamivudine before operation and used Lamivudine combined with low-dosage hepatitis B immunoglobulin after operation to prevent recurrence of HBV;meanwhile,the marker of hepatitisB,HBV-DNA and YMDD variant were monitored;liver biopsy testified the marker of hepatitis B by immunohistology. Results HBV-DNA of 11 positive preoperative cases significantly decreased after administration of Lamivudine more than one month (P<0.05) . No effect was seen on HBV-DNA in 8 positive preoperative cases after administration within one month (P>0.05) .The state of HBeAg before liver transplantation had no apparent relationship with HBV recurrence (P>0.05),while the positiveness of HBV-DNA did bear significant relationship with it (P<0.05) . And a significant correlation was also be found between HBV-DNA (titer >105copies/ml) and HBV recurrence (P<0.05) . The mean follow-up were 387 days (40~876d) ,there were three cases HBV recurrence with preoperative positive HBV-DNA and one case YMDD variant was detected.The recurrence rate of one year was 8.6%. Conclusion HBV-DNA can significantly decreased after administration of Lamivudine more than one month. The short-term curative effect on HBV recurrence by Lamivudine combined with low-dosage hepatitis B immunoglobulin is witnessed.The state of HBV-DNA before liver transplantation,especially in high titer, is a vital factor for HBV recurrence after liver transplantation.