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Liver transplantation for hepatitis B virus: Decreasing indication and changing trends

World Journal of Gastroenterology 2015年第26期21卷 8140-8147页

作者： Waleed Al-hamoudi Hussien Elsiesy Abdulrahman Bendahmash Nasser Al-masri safiyya ali Naglaa Allam Mohammed Al Sofayan Hamad Al Bahili Mohammed Al Sebayel Dieter Broering Sammy Saab Faisal Abaalkhail Gastroenterology Unit Department of MedicineCollege of MedicineKing Saud University Department of Liver Transplantation and Hepatobiliary Surgery King Faisal Specialist Hospital and Research Center National Liver Institute Menoufeya University David Geffen School of Medicine UCLA

AIM: To evaluate the indication and outcome of hepatitis B virus(HBV)-related liver transplantation(LT) in the era of newer antiviral ***: We collected data on all patients who underwent transplantation at King Faisal Specialist Hospital and Research *** data included demographic,perioperative and long-term postoperative follow-up data including viral serological markers,HBV DNA,and repeated liver *** January 1990 and January 2012,133 patients(106 males and 27 females) underwent LT for HBV-related cirrhosis at our *** patients were followed up frequently during the first year following transplantation,according to our standard protocol; follow-up visits occurred every 3-6 mo *** infection was definedas re-emergence of HBV-DNA or hepatitis B surface antigen(HBs Ag) while on *** patients transplanted prior to 1992 did not receive immediate posttransplant anti-HBV prophylaxis; all other patients were treated with HBIG and at least one nucleos(t)ide ***: One hundred and thirty-three patients underwent LT for HBV and were followed for a median of 82 mo(range: 1-274).The rates of post-LT survival and HBV recurrence during the follow-up period were 89% and 11%,*** following factors were associated with disease recurrence: younger age(44.3 ± 16.2 years vs 51.4 ± 9.9 years,P = 0.02),positive pretransplant hepatitis B e antigen(HBe Ag)(60% vs 14%,P < 0.0001),detectable pretransplant HBV DNA(60% vs 27%,P = 0.03),positive posttransplant HBs Ag(80% vs 4%,P < 0.0001) and positive posttransplant HBe Ag(27% vs 1%,P < 0.0001).Forty-four(33%) patients had hepatocellular carcinoma(HCC).In the first(pre-2007) group,HBV was the second leading indication for LT after hepatitis C virus infection.A total of 64 transplants were performed,including 46(72%) for decompensated HBV cirrhosis,12(19%) for decompensated cirrhosis complicated by HCC and 6(10%) for compensated cirrhosis complicated by ***

关键词： Hepatitis B Hepatitis C Non-alcoholicsteatohepatitis Liver transplantation Hepatocellularcarcinoma

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