HEPATITIS-B VACCINATION RESULTS IN 140 LIVER-TRANSPLANT RECIPIENTS

Background/Aims: Human autologous liver transplantation is possible du e to an. adequate suppression of the body's immune response. This also causes a higher hepatitis infection rate, making hepatitis prevention very important. Materials and Methods: We describe our experience wit h hepatitis B virus vaccination in 140 adult liver transplant recipien ts, transplanted from 1986 to 1994 with more than one year of follow-u p. Excluded were those who had hepatitis B surface antigens or antibod ies to those antigens before the transplant. The vaccination schedule was 0-1-2 months with a double dose of recombinant vaccine. Results: T he total response rate (surface antigen. antibodies>10 U) was 40% (56/ 140); the rate was 47.7% in men. and 26% in. women. At the end of the study, only 17.1% (24/140) of the patients had antibodies>10 U. The re sponse rate was higher in patients with antibodies to hepatitis B core antigen (66.6%) than. in those Lacking antibodies (31.7%), and more L ong lasting (42.4% vs 11.2%). The response rate in 116 patients with b ooster doses was 12.9%. Six correctly vaccinated patients (4.28%) acqu ired new hepatitis B virus infections after the operation. Conclusions : The total response rate in these patients is much lower than in the general population, and there is a rapid decline of titers, probably d ue to immunosuppression. The role of booster doses in these patients s hould be clarified.