Role of nucleoside/nucleotide analogues and low-dose hepatitis B immune globulin in prophylaxis of hepatitis B recurrence among cadaveric liver transplant recipients

Tokunbo Ajayi, Harry Luu, Behnam Saberi, James P. Hamilton, Bugra Tolga Konduk, Burak Özseker, Kawtar Al Khalloufi, Aliaksei Pustavoitau, Benjamin Philosophe, Andrew M. Cameron, Ahmet Gürakar

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background/Aims: Hepatitis B core antibody (HBcAb) positivity of the donor or the recipient may pose a risk of hepatitis B virus (HBV) reactivation following liver transplantation (LT). We retrospectively investigated patient survival and reactivation among recipients who were given low-dose Hepatitis B Immune Globulin (HBIG) plus antiviral agent (AV) versus AV only. Materials and Methods: Records of cadaveric LT recipients, between 2013 and 2016, with positive Hepatitis B surface Antigen (HBsAg) and/or HBcAb and recipients who had received LT from HBcAb-positive donors were reviewed. Patient characteristics and clinical data were extracted. Donor variables were retrieved from the United Network of Organ Sharing (UNOS) database. HBIG (1560 IU/mL) Intravenous (IV) was intraoperatively administered with three daily doses. Entecavir 1 mg daily was also given. STATA was used for statistical analysis. Results: There were 53 recipients; 39 (73.6%) were male with a median age of 59 y. HCV was the major indication in 30 (55.6%) patients. There were 28 recipients (52.8%) who received HBIG plus AV and 25 (47.2%) received AV only. The Model of End Stage Liver Disease (MELD) score between the groups were similar. Survival rates at 6, 12, and 24 months were 100% (n=53), 93.2% (n=44), and 100.0% (n=26), respectively. There was no reactivation; two recipients in the AV group and one in the HBIG plus AV group died within 12 months. Conclusion: This study supports the use of low-dose HBIG and AV for post-LT prophylaxis to be as effective as conventionally used high-dose HBIG (9600 IU) plus AV. Future prospective larger studies are warranted to examine the potential benefits of using AV alone without HBIG.

Original languageEnglish (US)
Pages (from-to)61-66
Number of pages6
JournalTurkish Journal of Gastroenterology
Volume29
Issue number1
DOIs
StatePublished - Jan 2018

Keywords

  • Hepatitis B
  • Liver transplant
  • Prophylaxis
  • Recurrence

ASJC Scopus subject areas

  • Gastroenterology

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