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Orthotopic liver transplantation for patients with hepatitis B virus–related liver disease
Author(s) -
Todo Satoru,
Demetris Anthony J.,
van Thiel David,
Teperman Lewis,
Fung John J.,
Starzl Thomas E.
Publication year - 1991
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840130402
Subject(s) - medicine , hepatology , hbsag , hepatitis b virus , liver transplantation , hepatitis b , hepatitis , virus , gastroenterology , immunology , liver disease , transplantation , hbeag
Fifty‐nine patients with prior hepatitis B virus infection underwent orthotopic liver transplantation. During the first 2 mo, mortality was not significantly different in the hepatitis B virus–infected group (25.5%) vs. a hepatitis B virus–immune control group (21%). Beyond 2 mo, the mortality, rate of graft loss, need for retransplantation and incidence of abnormal liver function were significantly higher in the hepatitis B virus–infected group. Treatment of the hepatitis B virus infection was attempted with passive immunization, combined active and passive immunization, α‐interferon or nothing. The clinical outcome was not significantly influenced by any of these therapies. However, of the patients who lived more than 60 days, 6 of 22 treated with active plus passive immunization were cleared of HBsAg, something achieved once in 16 patients treated with α‐interferon, never in 3 patients with passive immunization only and once in 4 patients with no therapy. In patients with recurrent hepatitis B virus infection, the pace of hepatitis development in the graft appeared to be accelerated, and this was particularly striking in patients who underwent multiple retransplantations at progressively shorter intervals. None of the patients who became HBsAg‐negative had HBeAg preoperatively. (H EPATOLOGY 1991;13:619–626.)