Clinical analysis of viral hepatitis B recurrence after liver transplantation for HBV-related liver diseases

Abstract

Objective This study focused on the recurrence risks of viral hepatitis B (VHB) after liver transplantation for hepatitis B virus (HBV)-related liver diseases. Methods A total of 599 patients undergoing liver transplantation due to HBV-related liver disease [hepatic cellular cancer (HCC), decompensated liver cirrhosis (DLC), acute liver failure (ALF)] were included in this study. All patients included in this study have been followed up for at least 12 months for liver biochemistry and HBV testing, altogether with the clinical presentation and outcomes. Treatment protocols about prevention of VHB recurrence in perioperative period and after liver transplantation, the time interval and influencing factors of VHB recurrence, and the disease prognosis were analyzed. Results Of the 599 patients, VHB recurrence were observed in 36 cases. The rate of VHB recurrence was 7.2% (23/319), 5.6% (13/232) and 0 (0/48) for HCC, DLC and ALF, respectively. The rate of VHB recurrence was 2.3%, 5.5% and 6% for 1 year, 5 years and 8 years, respectively. The rate of VHB recurrence in the lamivudine group was significantly higher than in enticavir group and combination therapy group [16.5% (22/133), 2.9% (8/280), 3.2% (6/186), respectively, P<0.05]. Conclusion HCC and DLC as liver transplantation indication are independent risk factors for VHB recurrance after liver transplantatuib. For liver transplantation patients with HBV-related liver disease, entecavir monotherapy and combination therapy (lamivudine and adefovir, or tenofovir) are both more effective on the prophylaxis of VHB recurrance than lamivudine monotherapy. Key words: Liver transplantation; Hepatitis B; Recurrence; Nucleoside analogue