治疗策略保护治疗策略保护儿童接受乙肝感染的肝脏移植

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Treatment strategy protects children who receive liver transplants from hepatitis B-infected donors

Researchers have found that a prophylaxis treatment can prevent new-onset hepatitis B in children who receive liver transplants from donors who were previously infected with hepatitis B virus (HBV) but had successfully cleared the virus. The findings are published in Liver Transplantation, a journal of the American Association for the Study of Liver Diseases.

Hepatitis B is a viral infection that attacks the liver and can lead to diseases including cirrhosis and liver cancer. The use of livers from deceased donors infected with hepatitis B has the potential to expand the donor pool, especially in areas where HBV is common; however, this may carry certain risks for recipients.

Studies have shown that using these livers can be safe as long as recipients receive proper prophylaxis treatments to prevent new-onset hepatitis B, but several different approaches exist, and it's unclear which is optimal.

In a new study, investigators led by Suk-Koo Lee, MD, PhD, of the Sungkyunkwan University School of Medicine, in Korea, describe their prophylaxis regimen and characterize the long-term outcome of 41 pediatric recipients of livers from donors previously infected with hepatitis B. The regimen consisted of HBV vaccine intramuscular injections given intermittently to maintain antibody levels against a hepatitis B protein above 100 IU/L. Hepatitis B immunoglobulin—which is prepared from the plasma of donors who have high levels of such antibodies—was also used during the first post-transplant year, and it was given to maintain a target antibody level above 200 IU/L. Only one case (2.4 percent) of new-onset hepatitis B occurred over a median follow-up period of 66 months post-transplant.

Dr. Lee noted that life-long monitoring of HBV status is necessary in these patients since new-onset hepatitis B has been known to occur long after transplantation. "Our regimen is as effective—or even more so—as previously used regimens, and the cost is far less. Also, it is safe to use and patients require less than one injection per year on average," he said. "Its safety, simplicity and cost-effectiveness make our regimen a better fit for pediatric liver transplant recipients, since they must receive hepatitis B prophylaxis longer than their adult counterparts."

Explore further: Researchers publish 'landmark' results for curing hepatitis C in transplant patients

More information: Sanghoon Lee et al. De Novo Hepatitis B Prophylaxis with Hepatitis B Virus Vaccine and Hepatitis B Immunoglobulin in Pediatric Recipients of Core Antibody-Positive Livers, Liver Transplantation (2015). DOI: 10.1002/lt.24372

Journal reference: Liver Transplantation search and more info website

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治疗策略保护谁接受肝脏移植的乙肝感染的捐助者子女

研究人员发现，预防治疗可预防新发乙肝谁接受肝脏移植从谁以前感染乙肝病毒（HBV），但已成功清除病毒的捐助者的孩子。该研究结果发表在肝移植，美国协会肝病研究杂志。

乙型肝炎是一种病毒感染攻击肝脏并能导致疾病，包括肝硬化和肝癌。使用从感染乙肝已故捐赠者的肝脏有扩大供体库，尤其是在地方乙肝是常见的潜力;然而，这可能携带的收件人一定的风险。

有研究表明，使用这些肝脏可以放心，只要收件人会收到适当的预防治疗，以防止新发乙肝，但几种不同的方法存在的，但目前还不清楚这是最佳的。

在新的研究中，研究人员为首的淑辜李，医学博士，成均馆大学医学院，韩国，描述他们的预防方案，并从以前感染与捐助者的表征肝脏的41儿科收件人的远期疗效B型肝炎的治疗方案包括了乙肝疫苗肌内注射给予间歇地维持对乙肝蛋白质高于100 IU / L抗体水平。乙肝免疫球蛋白是从谁拥有高水平这样的捐赠者的血浆制备的抗体，期间还第一次移植后一年使用，它被赋予维持高于200 IU / L的目标抗体水平。仅一例新发乙肝（2.4％）发生在中位随访期66个月后移植。

李博士指出，乙肝病毒状态终身监控是必要的，这些患者由于新发的乙肝已经知道移植后发生长。 “我们的方案是同样有效-或更是如此-与先前使用的治疗方案，而且成本也少得多，而且，它是安全的使用，并且患者需要小于一个喷射平均每年，”他说。 “它的安全性，简单性和成本效益，使我们的方案更适合小儿肝移植受者，因为他们必须接受B型肝炎的预防比其成年同行。”

进一步探讨：研究人员公布“里程碑”结果治疗丙型肝炎移植患者

更多信息：Sanghoon Lee等人。新发乙肝预防乙肝病毒疫苗和乙肝免疫球蛋白核心抗体阳性肝脏儿科收件人，肝移植（2015年）。 DOI：10.1002 / lt.24372

杂志引用：肝移植的搜索和更多信息网站