Histologic recurrence-free outcome after orthotopic liver transplantation for chronic hepatitis B

Recurrent hepatitis B (HB) following orthotopic liver transplantation (OLT) for chronic disease is common. However, an unpredictable minority of patie nts follow a recurrence-free course. Clinical, virologic, and pathologic da ta from patients surviving longer than 60 days (n=24) with pathologically c onfirmed nonrecurrence of HE following OLT fur chronic HE were reviewed to identify factors associated with nonrecurrence of HE. Nine of 24 patients h ad no histologic and immunohistologic evidence of recurrent HE. In addition to pre-OLT hepatitis B e antigen (HBeAg) negativity, coexisting delta and anti-MB therapy/prophylaxis, other acquired viral infections and their ther apy, and severe acute rejection due to noncompliance were considered the po ssible protective factors against HE recurrence in these 9 patients. Histol ogic and, particularly immunopathologic, evaluation of liver biopsies must be utilized in definitively diagnosing recurrence of HE.