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KMID : 0371320010600060640
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Journal of the Korean Surgical Society
2001 Volume.60 No. 6 p.640 ~ p.643
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Prophylaxis against Hepatitis B Recurrence Following Liver Transplantation in HBsAg(+) Patients Hepatitis B Immune Globulin vs Lamivudine -
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Lee Kwang-Woong
Park Jae-Berm
Cho Jae-Won
Kim Sung-Ju
Song Geon-Do
Choi Seong-Ho
Heo Jin-Seok
Kim Yong-Il
Lee Byung-Boong
Kim Jung-Han
Lee Suk-Koo
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Abstract
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Purpose
Thanks to hepatitis B immune globulin (HBIG) and antiviral agents such as Lamivudine , HBV cirrhosis is no longer a contraindication of liver transplantation. Actually it is frequent indication for liver transplantation in Korea.
However, to
date, the most effective HBV prophylaxis regimen has not been determined. The purpose of this study was to evaluate whether the regimen consisting of lamivudine and one-week HBIG for the hepatitis B virus (HBV) prophylaxis following liver
transplantation is as effective as a long-term therapy of high dose HBIG.
Methods
From May 1996 to December 1999, 58 patients among a total of 80 cases of liver transplantation were hepatitis B surface antigen positive preoperatively. They were grouped into two protocol regimens, the HBIG group and the Lamivudine
combination group, at random. 43 patients (19 patients in the HBIG group, twenty four patients in the Lamivudine combination group) who survived more than 90 days were included in this study. The recurrence was defined as the
conversion
of
HBs-Ag from negative to positive.
Results
There was no statistical significance between the two groups in regards to age, sex or the preoperative positive rate of HBeAg. The mean follow-up duration was 27 months (range from 6-55). Of the 43 patients, 5 patients were converted to HBs-Ag
positive
in serum; two were in the HBIG group and three in the Lamivudine combination group. There was no statistical significance in HBV recurrence rate between the two groups (p=0.97).
Conclusion
The combined therapy of lamivudine and one week HBIG has an effect equivalent to a long term therapy of high dose HBIG in HBV prophylaxis following liver transplantation.
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