High Viremia, Prolonged Lamivudine Therapy and Recurrent

liver411

<http://www3.interscience.wiley.com/journal/123563180/abstract>

American Journal of Transplantation
Volume 10 Issue 7, Pages 1649 - 1659
Published Online: 25 Jun 2010
© 2010 American Society of Transplantation and the American Society of
Transplant Surgeons

High Viremia, Prolonged Lamivudine Therapy and Recurrent Hepatocellular
Carcinoma Predict Posttransplant Hepatitis B Recurrence�€

J. Chun a , W. Kim b,*, B. G. Kim b , K. L. Lee b , K.-S. Suh c , N.-J. Yi c ,
K. U. Park d , Y. J. Kim a , J.-H. Yoon a and H. S. Lee a

a Department of Internal Medicine and Liver Research Institute, Seoul
National University College of Medicine, Seoul, Korea   b Department of
Internal Medicine, Seoul Metropolitan Government Seoul National University
Boramae Medical Center, Seoul, Korea   c Departments of Surgery and   d
Laboratory Medicine, Seoul National University College of Medicine, Seoul,
Korea
* Corresponding author: Won Kim, [email protected]

�€ Presented as a poster at the 44th Annual Meeting of the European
Association for the Study of the Liver (EASL) in Copenhagen, Denmark, April
22–26, 2009.

Copyright © 2010 American Society of Transplantation and the American Society
of Transplant Surgeons


ABSTRACT
Hepatitis B virus (HBV) recurrence following orthotopic liver transplantation
(OLT) is generally preventable by prophylaxis with hepatitis B immunoglobulin
(HBIG) and lamivudine (LAM). However, HBV recurrence sometimes develops
despite prophylaxis. This study assessed posttransplant outcomes and
identified predictors of HBV recurrence. We analyzed the outcomes of 209
consecutive patients positive for hepatitis B surface antigen who underwent
OLT, who received either combination prophylaxis with HBIG and LAM (89.0%) or
HBIG monoprophylaxis (11.0%). The median follow-up was 36.8 months (range,
1.0–84.4). Posttransplant HBV recurrence occurred in 22 patients (10.5%),
including 13 patients with drug-resistant mutations. HBV recurrence was
observed in six patients after hepatocellular carcinoma (HCC) recurrence.
Independent predictors of HBV recurrence were recurrent HCC (p < 0.001), LAM
therapy>1.5 years (p = 0.001) and high HBV DNA titers (≥105 copies/mL) at
OLT (p = 0.036). In conclusion, high viremia at OLT and prolonged exposure to
LAM should be further stressed as main predictors of HBV recurrence.

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Received 15 December 2009, revised 15 April 2010 and accepted for publication
27 April 2010

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1600-6143.2010.03162



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