Efficacy of Hepatitis B Immune Globulin for Prevention of De Novo Hepatitis B in Living-related Liver Transplantation.
- Author:
Sang Jong KIM
1
;
Soo Jung HWANG
;
Sung Eun PARK
;
Yon Ho CHOE
;
Suk Koo LEE
;
Jae Won JOH
;
Sung Joo KIM
;
Kwang Woong LEE
;
Jeong Meen SEO
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. cyh@smc.samsung.co.kr
- Publication Type:Original Article
- Keywords:
De novo hepatitis B;
Prevention;
Hepatitis B immune globulin (HBIg);
Liver transplantation
- MeSH:
Allografts;
Follow-Up Studies;
Hepatitis B Surface Antigens;
Hepatitis B virus;
Hepatitis B*;
Hepatitis*;
Humans;
Immunization, Passive;
Lamivudine;
Liver Transplantation*;
Liver*;
Medical Records;
Retrospective Studies;
Tissue Donors;
Vaccination
- From:Korean Journal of Pediatric Gastroenterology and Nutrition
2003;6(1):32-38
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Hepatic allografts from donors with hepatitis B core antibody have been demonstrated to transmit hepatitis B virus (HBV) infection to recipients after liver transplantation (LT). The efficacy of hepatitis B immune globulin (HBIg) to prevent de novo hepatitis B was investigated by comparing active immunization in the early phase to HBIg monotherapy in the late phase of pediatric liver transplants at Samsung Medical Center. METHODS: Among pediatric liver transplants, from May, 1996 to June, 2002, 15 recipients who were hepatitis B surface antigen (HBsAg) (-) received an allograft from a donor with hepatitis B core antibody (HBcAb) (+). Except two who died from unrelated causes, eleven of 13 recipients were HBsAb (+), and 2 were naive (HBsAb(-), HBcAb(-)). All patients were vaccinated for HBV before LT. In the early phase (January, 1997~November, 1997, 3 patients), HBsAb (+) recipients received booster vaccination after LT. In the late phase (December, 1997~, 10 patients), all recipients were given booster vaccination and received HBIg therapy in order to maintain HBsAb titer greater than 200 IU/L. Lamivudine was given in one case because of severe side effect of HBIg. We retrospectively analyzed the effect of the preventive therapy for de novo hepatitis B through medical records. RESULTS: De novo hepatitis B developed in three of 13 recipients (23.1%). All of 3 patients who received active immunization in the early phase became HBsAg (+) at 7~19 months after transplantation. One of them was naive before LT and the other two were HBsAb (+). All of 10 recipients who were given HBIg in the late phase remained HBsAg (-) at 7~55 months' follow-up. CONCLUSION: Passive immunization with HBIg was effective for prevention of de novo hepatitis B in HBsAg (-) recipients of hepatic allografts from HBcAb (+) donors.
