RECURRENT FULMINANT LIVER-FAILURE CAUSED BY HEPATITIS-B VIRUS AFTER LIVER-TRANSPLANTATION

We report a 44-year-old man who received a liver graft because of fulm inant liver failure due to hepatitis B virus. Nine months later a new episode of acute hepatitis B followed a fulminant course and led to an other transplantation. The patient died due to invasive aspergillosis and multiorgan failure 3 weeks after the second transplant. This case reveals that hepatitis B virus reinfection may also occur after transp lantation in patients with fulminant hepatitis B and under immunosuppr ession circumstances. Although immunoprophylaxis with hepatitis B hype rimmune globulin may prevent hepatitis B reinfection, it does not guar antee complete protection even in patients presumed to have low risk o f reinfection. Finally, this case confirms the high risk of fungal inf ections in patients with fulminant liver failure and the need to estab lish early antifungal therapy.