Etiology and prognosis of hepatitis B reinfection after orthotopic liver transplantation

Objective To investigate the etiology and prognosis of hepatitis B virus(HBV) reinfection after orthotopic liver transplantation(OLT).Methods Levels of HBV DNA,HBV mutation and liver function HBV mutation pre/post-operation in OLT patients were checked by followed up observation.All patients received standard therapy of lamivudine plus HBIG.Results From April 2004 to December 2005,20 patients(age range 28~60,median 46.9) accepted OLT in our center,12 cases were HBV-related end-stage cirrhosis,8 cases were HBV-related chronic acute liver failure(chronic severe hepatitis),and 3 cases died of liver failure post-OLT.Fourteen cases were followed up 60~84 months,6 cases of them appeared HBV mutation.3 cases HBV recurred and all of them were HBV-related chronic severe hepatitis within one year post-operation.Conclusion HBV mutation is the primary reason for HBV reinfection in the patients treated with Lamivudine and HBIG post-OLT.Patients with HBV-related chronic severe hepatitis and positive serum HBV DNA status pre-operation should be followed up with care for HBV reinfection.