scholarly journals Discontinuation of Passive Immunization Is Safe after Liver Transplantation for Combined HBV/HDV Infection

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 904
Author(s):  
Ramin Raul Ossami Saidy ◽  
Irina Sud ◽  
Franziska Eurich ◽  
Mustafa Aydin ◽  
Maximilian Paul Postel ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Overall Survival ◽  
Hepatitis B ◽  
Graft Function ◽  
Passive Immunization ◽  
Standard Regimen ◽  
Long Term Follow Up ◽  
Hdv Infection ◽  
End Stage

Patients after LT due to combined HBV/HDV infection are considered to be high-risk patients for recurrence of hepatitis B and D. To date, life-long prophylaxis with hepatitis B immunoglobulin (HBIG) and replication control with nucleos(t)ide analogs (NA) remains standard. We examined the course of 36 patients that underwent liver transplantation from 1989 to 2020 for combined HBV/HDV-associated end-stage liver disease in this retrospective study. Seventeen patients eventually discontinued HBIG therapy for various reasons. Their graft function, histopathological findings from routine liver biopsies and overall survival were compared with those that received an unaltered NA-based standard regimen combined with HBIG. The median follow-up was 204 and 227 months, respectively. The recurrence of HBV was 25% and did not differ between the groups of standard reinfection prophylaxis NA/HBIG (21.1%) and HBIG discontinuation (29.4%); (p = 0.56). No significant differences were found regarding the clinical course or histopathological aspects of liver tissue damage (inflammation, fibrosis, steatosis) between these two groups. Overall, and adjusted survival did not differ between the groups. Discontinuation of HBIG in stable patients after LT for combined HBV/HDV did not lead to impaired overall survival or higher recurrence rate of HBV/HDV infection in this long-term follow-up. Therefore, the recommendation of the duration of HBG administration must be questioned. The earliest time of discontinuation remains unclear.

Medical Problems Occurring During the Long-term Follow-up after Liver Transplantation

Swiss Surgery ◽  
2003 ◽  
Vol 9 (5) ◽  
pp. 237-241 ◽  
Author(s):  
Demirag ◽  
Bühler ◽  
Majno ◽  
Berney ◽  
Chilcott ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Metabolic Bone Disease ◽  
Long Term Results ◽  
Medical Problems ◽  
Metabolic Bone ◽  
Long Term Follow Up ◽  
End Stage ◽  
Patient Survival Rate

Liver transplantation is a standardized therapy for end-stage liver disease. With current immunosuppressive protocols and patient care, ten-year patient survival rate has reached 60%. Several medical complications may develop during this period, including renal dysfunction, hypertension, diabetes mellitus, hyperlipidemia, and metabolic bone disease. The aim of this article is to analyze long-term results of several clinical trials reporting common medical dysfunctions after liver transplantation and to discuss their management.

[141] LONG TERM FOLLOW-UP OF LIVER TRANSPLANTATION (OLT) FOR CHOLESTATIC AND AUTOIMMUNE END STAGE LIVER DISEASES

2007 ◽  
Vol 46 ◽  
pp. S63-S64
Author(s):  
L. Blasone ◽  
S. Fagiuoli ◽  
M. Colledan ◽  
M. Strazzabosco ◽  
M. Lenzi ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Diseases ◽  
Long Term Follow Up ◽  
End Stage

scholarly journals Reestablishment of Active Immunity against HBV Graft Reinfection after Liver Transplantation for HBV-Related End Stage Liver Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Shi-Chun Lu ◽  
Tao Jiang ◽  
Wei Lai ◽  
Yuan Liu ◽  
Jing Zhang ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis B ◽  
Low Dose ◽  
Antiviral Agents ◽  
Graft Loss ◽  
Antiviral Agent ◽  
Hbv Vaccination ◽  
Active Immunity ◽  
End Stage

Background. The aim of this study was to establish a hepatitis B virus (HBV) vaccination protocol among orthotopic liver transplantation (OLT) recipients under the coverage of a low-dose hepatitis B immunoglobulin (HBIG) combined with an antiviral agent prophylaxis protocol.Method. Two hundred OLT recipients were included in this study. The vaccine was injected at months 0, 1, 2, and 6. Low-dose HBIG combined with antiviral agent prophylaxis protocol was continued before reestablishment of active immunity against HBV in order to maintain a steady anti-HBs titer.Results. Active immunity against HBV was reestablished in 50 patients, for an overall response rate of 25%. Of the 50 patients, 24 discontinued HBIG without any HBV graft reinfection during a follow-up period of 26.13 ± 7.05 months. 21 patients discontinued both HBIG and antiviral agents during a follow-up period of 39.86 ± 15.47 months, and 4 patients among them appeared to be HBsAg positive. There was no recipient death or graft loss because of HBV reinfection.Conclusions. Vaccination preventing HBV reinfection for OLT recipients is feasible. The strategy withdrawal of HBIG with induction of active immunity against hepatitis B is reasonable for long-term survivors of OLT; however, discontinuation nucleoside analogues should be cautious.

scholarly journals Long term follow-up and outcome of liver transplantation from hepatitis B surface antigen positive donors

2017 ◽  
Vol 23 (12) ◽  
pp. 2095 ◽  
Author(s):  
Roberto Ballarin ◽  
Alessandro Cucchetti ◽  
Francesco Paolo Russo ◽  
Paolo Magistri ◽  
Matteo Cescon ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis B ◽  
Surface Antigen ◽  
Hepatitis B Surface Antigen ◽  
Long Term Follow Up

LONG-TERM FOLLOW-UP OF HEPATITIS B VIRUS-INFECTED RECIPIENTS AFTER ORTHOTOPIC LIVER TRANSPLANTATION

1994 ◽  
Vol 58 (5) ◽  
pp. 553-559 ◽  
Author(s):  
Volker König ◽  
Uwe Hopf ◽  
Peter Neuhaus ◽  
Jürgen Bauditz ◽  
Christian A. Schmidt ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Orthotopic Liver Transplantation ◽  
B Virus ◽  
Long Term Follow Up

scholarly journals Clinical and Histological Long-Term Follow-Up of De Novo HBV-Infection after Liver Transplantation

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 767
Author(s):  
Ramin Raul Ossami Saidy ◽  
Franziska Eurich ◽  
Maximilian Paul Postel ◽  
Eva Maria Dobrindt ◽  
Jasper Feldkamp ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis B ◽  
De Novo ◽  
Fibrosis Progression ◽  
Transplant Patients ◽  
Long Term Follow Up ◽  
De Novo Hepatitis B ◽  
The Moment

Background and Objectives: Development of hepatitis-B is considered a serious complication after liver transplantation. HBV de novo infection is a rather rare phenomenon, however it deserves attention in the era of donor organ shortage. The aim of the present analysis was to examine its course in liver transplant patients. Materials and Methods: Prevalence of de novo HBV-infections was extracted from our local transplant data base. Analysis focused on the moment of HBV-detection and on the long-term follow-up in terms of biochemical and histological changes over 30 years. Results: 46 patients were identified with the diagnosis of de novo hepatitis B. Median time from liver transplantation to diagnosis was 397 days (7–5505). 39 patients received antiviral therapy. No fibrosis progression could be detected, whereas the grade of inflammation significantly lessened from the moment of HBV detection to the end of histological follow-up over a median of 4344 days (range 123-9490). Patients with a poor virological control demonstrated a significantly poorer overall survival. Conclusions: De novo hepatitis B in liver transplant patients is a condition that can be controlled very well without significant fibrosis progression or graft loss if recognized on time within a regular transplant follow-up schedule.

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