摘要
BACKGROUND: In the 1990s, liver transplantation for hepatitis B virus (HBV) related-liver diseases was a very controversial issue because the graft was inevitably recurrent after liver transplantation. Significant progress has been made in the prophylaxis and treatment of recurrent hepatitis B after liver transplantation. This review covers the mechanisms, prophylaxis, and treatment of hepatitis B recurrent after liver transplantation. DATA SOURCES: Searching MEDLINE (1995-2004) for articles on liver transplantation. RESULTS: HBV reinfection after liver transplantation results from HBV particles in circulation or other extrahepatic sites. Hepatitis B immune globulin ( HBIG) was effective in reducing HBV reinfection and improving graft survival after liver transplantation. Lamivudine has also dramatically reduced the recurrence of HBV in the patient undergoing liver transplantation. CONCLUSIONS: Combination HBIG and lamivudine is the most effective porphylatic regimen. Lamivudine and adefovir are highly effective in treatment of HBV recurrence. HBV-related liver disease is no longer a contraindication for liver transplantation.
BACKGROUND: In the 1990s, liver transplantation for hepatitis B virus (HBV) related-liver diseases was a very controversial issue because the graft was inevitably recurrent after liver transplantation. Significant progress has been made in the prophylaxis and treatment of recurrent hepatitis B after liver transplantation. This review covers the mechanisms, prophylaxis, and treatment of hepatitis B recurrent after liver transplantation. DATA SOURCES: Searching MEDLINE (1995-2004) for articles on liver transplantation. RESULTS: HBV reinfection after liver transplantation results from HBV particles in circulation or other extrahepatic sites. Hepatitis B immune globulin ( HBIG) was effective in reducing HBV reinfection and improving graft survival after liver transplantation. Lamivudine has also dramatically reduced the recurrence of HBV in the patient undergoing liver transplantation. CONCLUSIONS: Combination HBIG and lamivudine is the most effective porphylatic regimen. Lamivudine and adefovir are highly effective in treatment of HBV recurrence. HBV-related liver disease is no longer a contraindication for liver transplantation.
