Significance of Hepatitis B Recurrence in Liver Transplantation Recipients

الملخص EN

Background.

A combination of antihepatitis B immunoglobulin and antiviral agents is the most common regimen for prophylaxis of hepatitis B recurrence after liver transplantation.

However, hepatitis B recurrence still happens.

The significance of hepatitis B recurrence is less mentioned.

Materials.

Forty-eight of the 313 hepatitis B liver transplant recipients having hepatitis B recurrence were included in this study.

The patients were divided into group A, the patients transplanted for hepatitis B-related liver failure, and group B, the patients transplanted for hepatitis B-related cirrhosis and HCC.

The clinical manifestations after hepatitis B recurrence were recorded.

Results.

Among the 48 patients with hepatitis B recurrence, 23 patients were in group A and 25 patients in group B.

The age was 51.6±9.4 years in group A and 52.8±6.4 in group B (p=0.869).

The MELD score prior to transplantation was 23.1±9.9 in group A patients and 12.9±5.6 in group B patients (p<0.001).

The median (interquartile) interval from transplantation to hepatitis B recurrence was 10 (2-19) months for group A patients and 13 (8.5-35) months for group B patients (p=0.051).

After hepatitis B recurrence, the liver function was almost normal in both groups.

In group B patients, 10 patients had HCC recurrence with 7 of 10 patients having hepatitis B recurrence earlier than HCC recurrence.

The interval between hepatitis B and HCC recurrence was 1 to 15 months.

The 1-, 3-, and 5-year survival rates were 82.6%, 73.9%, and 69.0%, respectively, for group A patients and 96%, 76%, and 68%, respectively, for group B patients (p=0.713).

Conclusion.

The patients have uneventful liver function under antiviral agent while hepatitis B recurred.

For the patients having HCC prior to transplantation, close monitoring of HCC recurrence is necessary if hepatitis B recurs.