Prevention and treatment of hepatitis B relapse after liver transplantation

Objectives To investigate the effect of orthotopic liver transplantation (O LT) on hepatitis B (HB)-related diseases and the efficiency of prevention a nd treatment with lamivudine on recurrence of hepatitis B posttransplant in China. Methods Orthotopic liver transplantation (OLT) under veno-venous bypass was performed in 10, of whom 9 males had hepatitis B and 1 female had hepatoce llular cancer (HCC) without HE pretransplant. Eight of the 9 males had fulm inant hepatitis IB (FHB) and they all had preoperative serious jaundice, as cites and coagulopathy. Six had encephalopathy; 1 was associated with acute renal failure, and 1 with gastrointestinal hemorrhage. Seven of the 10 pat ients had lamivudine to prevent reinfection with hepatitis B. Results Of the 8 patients who have survived for 2 - 12 months, 7 have survi ved for 6 - 12 months. Two died, one of recurrent FHB and the other from mu lti-organ failure (MOF). Seven preoperative HE patients of the 8 survivors have excellent liver function though 1 has positive HBsAg 6 months after OL T. One of the 8 survivors, the female with HCC pretransplant, suffered hepa titis B 6 months after OLT and her hepatic function has been gradually impr oving with lamivudine therapy. Conclusions OLT is an effective therapy for certain cases of FHB and HCC an d lamivudine may prevent recurrence of hepatitis B after OLT.