Patients with hepatitis B viral infection may have disease recurrence after orthotopic liver transplantation. Certain factors favor recurrence, while others factors reduce the risk. The immunosuppression required to prevent rejection can favor infection once initiated.
Parameter |
Finding |
Effect on Risk for Recurrence |
reason for transplant |
cirrhosis |
increase |
|
fulminant hepatic failure |
decrease |
|
retransplantation for graft failure due to recurrent HBV infection |
increase |
viral coinfection (HCV and/or HDV) |
present |
neutral |
|
absent |
increase |
high replicative status (HbeAg or HBV DNA) prior to transplant |
present |
increase |
|
absent |
neutral |
antiviral therapy with transplantation |
high dose HBIG (hepatitis B immune globulin) |
decrease |
|
lamivudine, other antiviral agents |
decrease |
Patients with recurrent HBV infection after transplantation tend to have a worse survival than other patients undergoing liver transplantation.
The use of immune globulin in combination with antiviral agents has markedly improved the prognosis of patients with HBV undergoing liver transplantation.
Purpose: To identify a transplant candidate with hepatitis B viral infection at risk for recurrence after liver transplantation.
Specialty: Infectious Diseases, Surgery, general, Gastroenterology
Objective: risk factors, adverse effects
ICD-10: B16, B18,