LIVER TRANSPLANTATION

liver411

November 2003 . Volume 9 . Number 11
Original Articles

Living donor liver transplantation for hepatitis B cirrhosis

Yasuhiko Sugawara, Masatoshi Makuuchi ,Junichi Kaneko
Nobuhisa Akamatsu ,Hiroshi Imamura ,Norihiro Kokudo

   Abstract
The living donor liver transplantation (LDLT) experience for patients with
hepatitis B virus (HBV) infection is still limited. Because LDLT can be
performed electively, it can provide an appropriate length of time to reduce
HBV DNA levels before the operation. This study aims to examine the
feasibility of our protocol for preventing HBV reinfection after LDLT. Of 20
patients analyzed, 15 patients had detectable serum HBV DNA when referred to
our hospital. Thirteen patients had hepatocellular carcinoma. All patients
were treated with lamivudine (100 mg/d) before LDLT. After LDLT, hepatitis B
immunoglobulin (HBIG) was administered to maintain serum antibody to
hepatitis B surface antigen titers at greater than 1,000 IU/mL for 1 year
and 200 IU/mL thereafter. Lamivudine was not administered postoperatively,
except for three patients with detectable serum HBV DNA just before LDLT.
All patients survived the operation. One patient died 229 days after LDLT of
carcinoma recurrence. In the other 19 patients, liver function has remained
normal and no viral relapse occurred postoperatively during a median
follow-up of 19 months. Perioperative use of lamivudine and indefinite HBIG
administration in the postoperative period might be a rational strategy for
preventing HBV reinfection after LDLT. (Liver Transpl 2003;9:1181-1184.)

   Publishing and Reprint Information
From the Department of Surgery, Artificial Organ and Transplantation
Division, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo,
Bunkyo-ku, Tokyo 113-8655, Japan.
Supported in part by a Grant-in-Aid for Scientific Research from the
Ministry of Education, Culture, Sports, Science and Technology of Japan and
a Grant-in-Aid for Research on Human Genome, Tissue Engineering, Food
Biotechnology, Health Sciences Research Grants from the Ministry of Health,
Labor and Welfare of Japan.

Address reprint requests to Yasuhiko Sugawara, MD, Artificial Organ and
Transplantation Division, Department of Surgery, Graduate School of
Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655,
Japan. Telephone: 81-3-3815-5411; FAX: 81-3-5684-3989; E-mail:
[email protected]
Copyright © 2003 by the American Association for the Study of Liver Diseases
1527-6465/03/0911-0008$30.00/0
doi:10.1053/jlts.2003.50237

nickcava

关于LTx治疗HB，Samuel D et al 1993年在N Engl J M 上发表过一篇经典文献，是一个欧洲多中心研究，建议有兴趣的人去看一看。