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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
6
|
| pubmed:dateCreated |
1997-12-4
|
| pubmed:abstractText |
The presence of a positive hepatitis B surface antigen (HBsAg) has been considered a highly questionable indication for orthotopic liver transplantation. We report our experience in the treatment of HBsAg-positive HBV-DNA-negative cirrhotics with liver transplantation, whether or not followed by passive prophylaxis with specific immunoglobulins. Of the 123 cirrhotics who received transplants at our institution since May 1986, 39 (31.7%) were HBsAg positive; of these, 1 was HBV-DNA positive, and 4 were hepatitis Be antigen (HBeAg) positive. Since April 1991, 25 HBsAg-positive HBV-DNA-negative cirrhotics have undergone an original protocol with the periodical intramuscular administration of 5,000 IU of specific immunoglobulins starting in the anhepatic phase and lasting for at least 1 year. There were no differences among cirrhotics in terms of operative mortality and long-term survival with respect to the presence of the HBsAg. Of the 35 HBsAg-positive HBV-DNA-negative patients having a follow-up of 1 month or longer, 12 (34.3%) developed HBsAg recurrence; of them, 4 (33.3%) had received a complete prophylaxis, whereas 8 (66.7%) had not. The recurrence rate was 80% (8 out of 10) in the group of patients who had not received the prophylaxis and 16% (4 out of 25) in the group who had received the prophylaxis (P = .0003). The actuarial recurrence rate in the treated patients was 20.2% and 20.2% after 1 and 3 years, respectively, whereas in the untreated group it was 60.0% and 70.0% (P < .01). The hazard of recurrence of treated patients was reduced to 24.9% compared with untreated patients. Liver transplantation can be performed in HBsAg-positive HBV DNA negative patients without an increase in the operative risk or a worsening of long-term results. Immunoglobulin prophylaxis seems to be effective in preventing hepatitis recurrence after transplantation.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:chemical | |
| pubmed:status |
MEDLINE
|
| pubmed:month |
Nov
|
| pubmed:issn |
1074-3022
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
2
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
418-25
|
| pubmed:dateRevised |
2006-11-15
|
| pubmed:meshHeading |
pubmed-meshheading:9346687-Adolescent,
pubmed-meshheading:9346687-Adult,
pubmed-meshheading:9346687-Child,
pubmed-meshheading:9346687-DNA, Viral,
pubmed-meshheading:9346687-Female,
pubmed-meshheading:9346687-Follow-Up Studies,
pubmed-meshheading:9346687-Graft Rejection,
pubmed-meshheading:9346687-Hepatitis B, Chronic,
pubmed-meshheading:9346687-Hepatitis B Surface Antigens,
pubmed-meshheading:9346687-Humans,
pubmed-meshheading:9346687-Immunoglobulins,
pubmed-meshheading:9346687-Immunotherapy,
pubmed-meshheading:9346687-Liver Cirrhosis,
pubmed-meshheading:9346687-Liver Transplantation,
pubmed-meshheading:9346687-Male,
pubmed-meshheading:9346687-Middle Aged,
pubmed-meshheading:9346687-Prognosis,
pubmed-meshheading:9346687-Proportional Hazards Models,
pubmed-meshheading:9346687-Recurrence,
pubmed-meshheading:9346687-Retrospective Studies,
pubmed-meshheading:9346687-Statistics, Nonparametric,
pubmed-meshheading:9346687-Survival Rate
|
| pubmed:year |
1996
|
| pubmed:articleTitle |
Liver transplantation in HBsAg-positive HBV-DNA--negative cirrhotics: immunoprophylaxis and long-term outcome.
|
| pubmed:affiliation |
Second Department of Surgery, University of Bologna, S. Orsola Hospital, Italy.
|
| pubmed:publicationType |
Journal Article,
Clinical Trial,
Research Support, Non-U.S. Gov't
|