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KMID : 0361120030170010078
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Korean Journal of Transplantation
2003 Volume.17 No. 1 p.78 ~ p.82
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Prevention of de novo Hepatitis B Infection from HBcAb Positive Donors in Living Donor Liver Transplantation
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이광웅/Kwang Woong Lee
이대성/조재원/김성주/최성호/허진석/최연호/이석구/Dae Sung Lee/Jae Won Joh/Sung Ju Kim/Sung Ho Choi/Jin Seok Heo/Yeon Ho Choi/Suk Koo Lee
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Abstract
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PURPOSE: HBV prophylaxis is necessary to prevent de novo hepatitis B infection from HBcAb positive donors. However, it is somewhat controversial in which protocol is more effective, and whether it is necessary to administer the HBV prophylaxis for HBsAb
positive recipients. In this study, we attempted to elucidate whether it is necessary to administer the HBV prophylaxis for HBsAb positive patients and to evaluate the efficacy of HBIG monotherapy protocol. METHODS: From May 1996 to July 2001, 58 donors
(45.3%) were HBcAb positive among 128 donors who were examined for HBcAb. Eighteen HBcAb positive grafts were transplanted to HBsAg negative recipients. Four patients died of unrelated causes were excluded. Of 14 study cases, 12 recipients were HbsAb
positive, and 2 were negative. Among 12 HBsAb positive recipients, 3 were HbcAb positive simultaneously. In early period (Nov. 1997~Nov. 1998), only HBV vaccination was applied for de novo infection prophylaxis. In late period (since Dec. 1998),
regardless of HBsAb positivity in recipients, HBIG was administered from the beginning of liver transplantation. RESULTS: The overall de novo HBV infection from HBcAb positive donors was 21.4 % (3/14). All 3 recipients without HBIG prophylaxis presented
de novo HBV infection. Two of them were HBsAb positive postoperatively. No de novo HBV infection occurred in recipients with HBIG prophylaxis. CONCLUSION: It is necessary to administer the HBV prophylaxis even for vaccinated HBsAb positive patients and
HBIG monotherapy protocol is effective to prevent de novo hepatitis B infection from HBcAb positive donors in living donor liver transplantation.
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KEYWORD
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