Application of active immunization in the prevention of de novo hepatitis B virus infection after pediatric liver transplantation with HBcAb positive donor liver
10.3760/cma.j.issn.2095-4352.2017.10.013
- VernacularTitle:主动免疫在预防HBcAb阳性供肝儿童肝移植术后新发乙型肝炎病毒感染中的应用
- Author:
Yufeng CUI
1
;
Wei LU
;
Wei GAO
;
Chong DONG
;
Chao HAN
;
Yihe LIU
Author Information
1. 300192,天津医科大学一中心临床学院
- Keywords:
Liver transplantation;
Child;
Active immunization;
Hepatitis B virus
- From:Chinese Critical Care Medicine
2017;29(10):926-930
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of active immunization on prevention of post-transplantation de novo hepatitis B virus (HBV) infection in patients receiving liver grafts from hepatitis B core antibody (HBcAb) positive donors.Methods A retrospective analysis was conducted. Eighty-seven children undergoing liver transplantation from HBcAb positive donors admitted to Tianjin First Center Hospital from October 2012 to December 2016 were enrolled, and the data of donors and recipients were collected. The hepatitis B vaccine was given before operation for hepatitis B surface antibody (HBsAb) >1000 U/L; hepatitis B immunoglobulin (HBIG) 100 U/kg was given during the operation, in order to prevent children from HBV infected by obtaining passive immunity quickly, children with HBsAb< 200 U/L after operation were injected with hepatitis B vaccine for booster immunization. HBV markers and liver function of recipients were determined before liver transplantation and during the follow-up, which up to April 2017. According to the children got de novo HBV infection after operation or not, the preventive effect of active immunization before and after transplantation operation on HBV infection was analyzed and compared.Results In 87 children who received HBcAb positive donor livers, 9 (10.3％) developed de novo HBV infection, which occurred in 16 (10, 25) months after liver transplantation. Among the 9 children with HBV infection, 7 children had HBsAb < 1000 U/L before the operation, the ratio was statistically increased as compared with the children without HBV infection [77.8％ (7/9) vs. 37.2％ (29/78),P < 0.05]. After the transplantation, 62 children of 78 without HBV infection showed a good response to hepatitis B vaccination, 1 child after inoculation of hepatitis B vaccine, the titer of HBsAb was still less than 200 U/L, 15 children without administration of hepatitis B vaccine, only with HBIG injection for prevention. The HBsAb of children with de nove HBV infection were less than 200 U/L after operation, the ratio was significantly increased as compared with children without HBV infection [100.0％ (9/9) vs. 20.5％ (16/78),P < 0.01].Conclusions The establishment of active immunization method can effectively prevent children with de novo HBV infection occurred inpediatric recipients from HBcAb positive donors with preventive treatment.
