Evaluation of the changes of HBV serum markers and HBV DNA and the effects of perioperative factors after liver transplantation.
- Author:
Ying-mei TANG
1
;
Gui-hua CHEN
;
Xiao-shun HE
;
Xiao-feng ZHU
;
Min-hu CHEN
Author Information
- Publication Type:Journal Article
- MeSH: Adult; DNA, Viral; blood; Female; Hepatitis B Surface Antigens; blood; Hepatitis B e Antigens; blood; Hepatitis B virus; isolation & purification; Hepatitis B, Chronic; complications; surgery; Humans; Liver Cirrhosis; surgery; virology; Liver Transplantation; Male; Middle Aged; Postoperative Period; Retrospective Studies
- From: Chinese Journal of Hepatology 2005;13(3):164-167
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo study the changes of HBV markers and HBV DNA and the perioperative factors influencing them after orthotopic liver transplantation (OLT).
METHODSA retrospective study was undertaken. Data was collected from 97 patients in the First Affiliated Hospital of Sun Yat-sen University from March 1999 to October 2003. Patients were investigated on the 7-14, 14-30, 30-90, 90-180, 180-360 and 360- days after OLT. All the patients who received OLT were serum HBV positive before their operations.
RESULTSKinetic expressions of HBV serum marker and HBV DNA were established. A few patient's HBeAg was negative (8%) before their operation. Within 7 day following surgery, no patient was HBeAg positive. However, the rate of HBeAg positive increased on the 90-180 day following surgery. The postoperation time of taking lamivudine was different between patients with HBeAg seroconversion and of those without (U = 88.5). Peaks occurred within 14 d of HBsAg negative and 14-30 d of anti-HBs positive after operation. Then they decreased and minimized at 90-180 day after liver transplantation. Patients who suffered more bleeding during the operation were more likely to be anti-HBs positive (3800ml vs. 3000ml, U = 8193.0) and HBsAg negative in serum within 2 week (5200ml vs. 4200ml, U = 1648.5) after OLT. While patient's who received more blood transfusion (1000ml vs. 1600ml, U = 9796.0) during operation were not likely to be anti-HBs positive in serum after surgery. Furthermore, the time of infusing HBIg did not affect the state of anti-HBs (U = 1252.5). At the same time, there were no correlations between the change of HBsAg in serum and in the method of operation (chi2 = 0.042). During this process, presentation of anti-HBc changed a little.
CONCLUSIONThe advantages brought on by operative factors become blunt 7-14 d following OLT. More attention should be taken to avoid reinfection of HBV 90-180 day after OLT. Tyrosine-methionine-aspartic acid-aspartic acid (YMDD) mutation of HBV is more likely to occur when taking lamivudine longer. Then, HBV DNA should be monitored and a liver biopsy should be scheduled regularly after OLT.
