Prophylactic Effect of Lamivudine Monotherapy Against Hepatitis B Recurrence Following Liver Transplantation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YAN Maolin , YAN Lnan , LI Bo , ZENG Yong , WEN Tianfu , WANG Wentao , YANG Jiayin , XU Mingqing , LI Zhihui.

Liver Transplantation Group of Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Lamivudine HBV recurrence Liver transplantation

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【Abstract】ObjectiveTo investigate the prophylactic effect of lamivudine monotherapy on the recurrence of hepatitis B after liver transplantation.
MethodsThirtyone patients with hepatitis B related benign decompensated cirrhosis who underwent liver transplantation between February 1999 to June 2002 and survived more than 3 months were analyzed retrospectively. Lamivudine was administered to each patient after operation and some patients before operation for the prophylaxis of HBV recurrence. The HBV markers and HBV DNA in serum and bioptic liver tissues in all patients were evaluated before and after operation.
ResultsTotal HBV recurrence rate was 19.4％（6/31） during average 38.2 months (3.2-70.2 months) follow up. HBV recurrence rate was 7.1％(2/28), 16.0％(4/25), 26.1％(6/23) and survival rate was 87.1％(27/31), 80.6％(25/31), 66.1％(20.5/31) after 1-, 3-and 5-year, respectively. One hundred milligram lamivudine administration peroral daily for 2 weeks prior to transplantation enable HBeAg 54.5％(6/11) and HBV DNA 50.0％(5/10) positive patients convert to negative respectively.
ConclusionPreoperative administration of lamivudine monotherapy can effectively prevent allograft from HBV re-infection after liver transplantation. Lamivudine should be used to convert HBV DNA and HBeAg to negative.

Citation： YAN Maolin,YAN Lnan,LI Bo,ZENG Yong,WEN Tianfu,WANG Wentao,YANG Jiayin,XU Mingqing,LI Zhihui.. Prophylactic Effect of Lamivudine Monotherapy Against Hepatitis B Recurrence Following Liver Transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2006, 13(2): 205-207下转210. doi: Copy

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14.	Maruyama T, Mitsui H, Hanajiri K, et al. AntiHBs antibodies produced after liver transplantation: from the donor or the recipient?.
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16.	郑树森，吴健，王伟林，等. 拉米夫定预防肝移植术后乙型肝炎病毒再感染的作用 [Ｊ]. 中华医学杂志， 2002； 82（7）∶445.
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18.	Akay S, Karasu Z, Akyildiz M, et al. Adefovir treatment in posttransplant hepatitis B virus infection resistant to lamivudine plus hepatitis B virus immunoglobulin.
19.	Angus P, Vaughan R, Xiong S, et al. Resistance to adefovir dipivoxil therapy associated with the selection of a novel mutation in the HBV polymerase.
20.	Zoulim F. Treatment of preand postliver transplantation HBVinfection: Should we aim at combination therapy? [Ｊ]. Hepatology, 2003； 38(6)∶1353.
21.	Sponseller CA, Bacon BR, Disbisceglie AM. Clinical improvement in patients with decompensated liver disease caused by hepatitis B after treatment with lamivudine [Ｊ]. Liver Transpl,2000； 6(6)∶715.
22.	Starkel P, Cicarelli O, Lerut J, et al. Limited lamivudine and longterm hepatitis B immunoglobulin immunoprophylaxis for prevention of hepatitis B recurrence after liver transplantation [Ｊ]. Transplantation, 2002； 74(3)∶408.

1. [Ｊ]. Hepatology, 1991； 13(4)∶619.
2. [Ｊ]. Hepatology, 2002； 35(6)∶1528.
3. [Ｊ]. Hepatogastroenterology, 1997； 44(15)∶808.
4. [Ｊ]. Transplant Proc， 1997； 29(6)∶2687.
5. [Ｊ]. Hepatology, 2003； 37(1)∶36.
6. [Ｊ]. Hepatology， 2003； 38(1)∶271.
7. [Ｊ]. Transplant Proc，2004； 36(9)∶2768.
8. [Ｊ]. Gastroenterology, 2003； 125(1)∶292.
9. Todo S, Demetris A, Van Thiel D, et al. Orthotopic liver transplantation for patients with hepatitis B virusrelated liver disease.
10. Steinmuller T, Seehofer D, Rayes N, et al. Increasing applicability of liver transplantation for patients with hepatitis Brelated liver disease.
11. BenAri Z, Shmueli D, Mor E, et al. Beneficial effect of lamivudine treatment of advanced and decompensated liver disease due to hepatitis B.
12. Nery JR, Weppler D, Rodiriguez M, et al. Efficacy of lamivudine in controlling hepatitis B virus recurrence after liver transplantation.
13. Lo CM, Fung JT, Lau GK, et al. Development of antibody to hepatitis B surface antigen after liver transplantation for chronic hepatitis B.
14. Maruyama T, Mitsui H, Hanajiri K, et al. AntiHBs antibodies produced after liver transplantation: from the donor or the recipient?.
15. Seehofer D, Rays N, Steinmuller T, et al. Viral load at the time of liver transplantation and risk of hepatitis B virus recurrence [Ｊ]. Liver Transpl, 2005; 11(4)∶402.
16. 郑树森，吴健，王伟林，等. 拉米夫定预防肝移植术后乙型肝炎病毒再感染的作用 [Ｊ]. 中华医学杂志， 2002； 82（7）∶445.
17. Steinberg JL, Yeo W, Zhong S, et al. Hepatitis B virus reactivation in patients undergoing cytotoxic chemotherapy for solid tumours: precore/core mutations may play an important role [Ｊ]. J Med Virol, 2000； 60(3)∶249.
18. Akay S, Karasu Z, Akyildiz M, et al. Adefovir treatment in posttransplant hepatitis B virus infection resistant to lamivudine plus hepatitis B virus immunoglobulin.
19. Angus P, Vaughan R, Xiong S, et al. Resistance to adefovir dipivoxil therapy associated with the selection of a novel mutation in the HBV polymerase.
20. Zoulim F. Treatment of preand postliver transplantation HBVinfection: Should we aim at combination therapy? [Ｊ]. Hepatology, 2003； 38(6)∶1353.
21. Sponseller CA, Bacon BR, Disbisceglie AM. Clinical improvement in patients with decompensated liver disease caused by hepatitis B after treatment with lamivudine [Ｊ]. Liver Transpl,2000； 6(6)∶715.
22. Starkel P, Cicarelli O, Lerut J, et al. Limited lamivudine and longterm hepatitis B immunoglobulin immunoprophylaxis for prevention of hepatitis B recurrence after liver transplantation [Ｊ]. Transplantation, 2002； 74(3)∶408.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Prophylactic Effect of Lamivudine Monotherapy Against Hepatitis B Recurrence Following Liver Transplantation

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