Prevention and treatment of hepatitis B virus reinfection after orthotopic Iiver transplantation

Objective To investigate the strategy and outcome of prevention of hepatitis B virus(HBV) reinfection after orthotopic liver transplantation(OLT).Methods A total of 120 patients with chronic fulminant hepatitis B,end-stage of liver cirrhosis and liver carcinoma were given hepatitis B immunoglobulin(HBIG) plus lamivudine or adefovir after OLT to prevent HBV reinfection.The serum HBV and HBV DNA were determined and clinical observation were performed.Results Follow-up time ranged from 23-59(median 45.2) months.Four patients had reinfection with positivity of HBsAg,HBeAb and HBcAb,the serum HBV DNA was also positive.All 4 patients became HBV-DNA negative after treatment and folloed-up for 19-26 months,but HBsAg remained positive.Conclusions HBIG plus lamivudine or adefovir can effectively prevent HBV reinfection after OLT.Load level of HBV-DNA before OLT was related with HBV reinfection after operation.