Clinical Analysis Of The Risk Factors Of Hepatitis B Virus Recurrence After Liver Transplantation For HBV-related Liver Diseases

Objective:Hepatitis B virus (HBV) recurrence is an important cause of post-liver transplant graft failure. This study focus on the risk factors of the HBV recuurence after liver transplantation for HBV-related liver diseases.Methods:A total of599patients undergoing liver transplant due to HBV-related liver disease [Hepatic cellular cancer (HCC), chronic hepatitis B (CHB) with cirrhosis and hepatic decompensation, acute liver failure (ALF) associated with hepatitis B] in the liver transplant center, the First Affiliated Hospital, School of Medicine, Zhejiang University from30th Dec2007to1st Jan2014, were included in this study. All patients included in this study have been followed up for at least12month for liver biochemistry and HBV testing, altogether with the clinic presentation and outcom. Treatment protocols about prevention of HBV recurrence in perioperative period and after liver transplantation, HBV recurrence time, influence factors of HBV recurrence, and the disease prognosis were analyzedResults:Of the599patients,36cases of HBV recurrence were observed. The rate of HBV recurrence is7.2%(23/319),6.1%(13/212) and0(0/68) for HCC, CHB and ALF, respectively. The rates of HBV recurrence are2.3%,5.5%.6%for1year.5years and8years, respectively. The rate of HBV recurrence of the lamivudine group is significantly higher than enticavir group and combination therapy group.[16.5%(22/111),2.9%(8/272),3.2%(6/180), respectively, P<0.05]Conclusions:HCC and decompesated CHB as liver transplant indication are independent risk factors for HBV recurrance after liver transplant. For liver transplant patients with HBV-related liver disease who were on low-dose HBIG injection, entecavir monotherapy and combination therapy (lamivudine and adefovir, or tenofovir) are both more effective on the prophylaxis of HBV recurrance than lamivudine monotherapy.