Research Of De Novo Hepatitis B Virus Infection In Pediatric Living Donor Liver Transplantation

Objective With the development of liver transplantation surgical techniques, liver transplantation has become an effective treatment for end-stage liver disease. Primary disease biliary atresia or metabolic disease in infants and children underwent liver transplantation has become the radical treatment of pediatric with end-stage liver disease, and save their lives increasingly. Use of immunosuppressants after liver transplantation, and physical state after pediatric, can increase the risk of DNHB infection. To investigate the incidence of de novo hepatitis B virus(HBV) infection after pediatric living donor liver transplantation(LDLT) and to analyze the risk factors associated with this de novo HBV infection.Methods This retrospective analysis of the July 2010-July 2014 children receiving clinical data for living donor liver transplantation recipients. A retrospective analysis.Exclusion criteria included lost, incomplete, within six months of death. All selected cases of children records, including: donor and recipient sex, age, date of surgery,preoperative and postoperative vaccination situation; preoperative and postoperative HBV serological markers: HBs Ag, Anti-HBs, HBe Ag, Anti- HBe, Anti-HBc;preoperative and postoperative serum HBV-DNA(<100IU / ml, negative); PELD score before liver transplantation; Child-Pugh score; operative time, intraoperative HBIG amount of intraoperative blood transfusion(red blood cells, The amount of plasma); The prevention of hepatitis B virus postoperative and follow-up. All clinical data were followed until December 2014.Results One hundred and six pediatric LDLT recipients were followed up for a median of 19.5 mo. Nine recipients developed De novo HBV infection(9/106,8.39%). Anti-HBc positive donor group’s, eight recipients developed novo HBV infection(8/45, 17.78%). Anti-HBc positive donor group’s, fourteen recipients using nucleoside analogues therapy prophyaxis in postoperative, they haven’t been developing de novo HBV infection for end of the follow-up. Without prophylactic HBV therapy in postoperative, eight recipients developed de novo HBV infection( 8/31, 25.8%). Anti-HBc positive donor group’s, we have to using nucleoside analogues anti-HBV treatment with prophylactic, and preoperative anti-HBs titers associated with de novo HBV postoperative,(P = 0.0043,P = 0.036).Preoperative 14 patients with hepatitis B vaccine in anti-HBc positive donor group’s, don’t have de novo HBV.Conclusion Anti-HBc positive pediatric living donor liver transplantation incidence of DNHB was significantly higher than the Anti-HBc negative pediatric, living donor liver transplantation incidence of DNHB.Anti-HBc positive donor ’s recipients need to use nucleoside analogues to prevent the occurrence of de novo HBV, preoperative of donor and recipient get vaccinate hepatitis B counld be prevention strategies for de novo HBV postoperative.