2011, Number 4
<< Back Next >>
Ann Hepatol 2011; 10 (4)
The role of hepatitis B immunoglobulin in hepatitis B related liver transplantation: Canadian Transplant Centre Position Paper
Levstik M, Wong P, Greanya ED, Yoshida EM
Language: English
References: 22
Page: 441-444
PDF size: 38.19 Kb.
ABSTRACT
Introduction. Hepatitis B virus (HBV) related liver transplant (LT) recipients face a high risk of HBV reinfection
in the absence of continuous post-operative HBV prophylaxis. Combination HBV prophylaxis with hepatitis
B immune globulin (HBIg) and nucleos(t)ide anti-viral agents prevents HBV recurrence in 90 to 100% of
patients who undergo transplantation for hepatitis B and is considered the standard of care in Canada.
Post liver transplant HBV prophylaxis protocols vary with regard to the dosing, duration and routes of HBIg
administration. All Canadian transplant centres managing liver transplant patients were surveyed as to
their HBV transplant protocols.
Results. Results of the survey showed that the majority of the Canadian
transplant centres use an oral antiviral in combination with long term or indefinite HBIg for prevention of
HBV recurrence post liver transplantation. Studies were done to test new protocols using lower HBIg doses
given intramuscularly or subcutaneously alone or in combination with antiviral agents.
Conclusion. Long
term HBIg administration post transplantation in combination with antiviral agents is an integral part of Canadian
HBV related liver transplant protocol.
REFERENCES
Canadian Organ Replacement Register (CORR). Canadian Institute for Health Information. Health Services Databases. Available from: http://www.cihi.ca
Gane E. Hepatitis B immunoglobulin immunoprophylaxis for hepatitis B: high, low or no dose. Liver Transplant 2010; 16: S36-S39.
Samuel D, Muller R, Alexander G, Fassati L, Ducot B, Benhamou JP, Bismuth H. Liver transplantation in European patients with the hepatitis B surface antigen. N Engl J Med 1993; 329: 1842-47.
McGory RW, Ishitani MB, Oliveira WM, Stevenson WC, Mc- Cullough CS, Dickson RC, Caldwell SH, et al. Improved outcome of orthotopic liver transplantation for chronic hepatitis B cirrhosis with aggressive passive immunization. Transplantation 1996; 61: 1358-64.
Tchervenkov JI, Tector AJ, Barkun JS, Sherker A, Forbes CD, Elias N, Cantarovich M, et al. Recurrence-free longterm survival after liver transplantation for hepatitis B using interferon-alpha pretransplant and hepatitis B immune globulin posttransplant. Ann Surg 1997; 226: 356-65.
Kim WR, Poterucha JJ, Kremers WK, Ishitani MB, Dickson ER. Outcome of liver transplantation for hepatitis B in the United States. Liver Transpl 2004; 10: 968-74.
Roche B, Samuel D. Liver transplantation for hepatitis B virus-related liver disease: indications, prevention of recurrence and result. J Hepatol 2003; 39: S181-S189.
Shouval D, Samuel D. Hepatitis B immune globulin to prevent hepatitis B virus graft reinfection following liver transplantation: a concise review. Hepatology 2000; 32: 1189-95.
Schilling R, Ijaz S, Davidoff M, Lee JY, Locarnini S, Williams R, Naoumov NV. Endoscytosis of hepatitis B immunoglobulin into hepatocytes inhibiti the secretion of hepatitis B virus surface antigen and virions. J Virol 2003; 77: 8882-92.
Terrault NA, Zhou S, Combs C, Hahn JA, Lake JR, Roberts JP, Ascher NL, et al. Prophylaxis in liver transplant recipients using a fixed dosing schedule of hepatitis B immunoglobulin. Hepatology 1996; 24: 1327-33.
Samuel D. The option of liver transplantation for hepatitis B: Where are we? Digest Liver Dis 2009; 41S: S185-S189.
Terrault NA, Kilic M, Karademir S, Karasu Z, Astarcioglu I, Genereux M, Dixit J, et al. HepaGam B after liver transplant in patients with hepatitis B virus. US Gastroenterol Rev 2007; 2: 39-45.
Singham J, Greanya ED, Lau K, Erb SR, Partovi N, Yoshida EM. Efficacy of maintenance subcutaneous hepatitis B immune globulin (HBIG) post-transplant for prophylaxis against hepatitis B recurrence. Ann Hepatol 2010; 9: 166-71.
Yoshida EM, Erb SR, Partovi N, Scudamore CH, Chung SW, Frighetto L, Eggen HJ, et al. Liver transplantation for chronic hepatitis B infection with the use of combination lamivudine and low-dose hepatitis B immune globulin. Liver Transpl Surg 1999; 5: 520-5.
Canadian Transplant HBIg Forum, August 13, 2010, Vancouver, BC.
Angus PW, Patterson SJ, Strasser SI, McCaughan GW, Gane E. A randomized study of adefovir dipivoxil in place of HBIG in combination with lamivudine as post-liver transplantation hepatitis B prophylaxis. Hepatology 2008; 48: 1460-6.
Teperman L, Spivey J, Poordad F, Schiano T, Bzowej N, Pungpapong S, Martin P, et al. Emtricitabine/tenofovir combination +/- HBIG post-orthotopic liver transplantation to prevent hepatitis B recurrence in patients with normal to moderate renal impairment. J Hepatol 2010; 52: S12-S13.
Gane E, Strasser S, Patterson S, McCaughan G, Angus P. A prospective study on the safety and efficacy of lamivudine and adefovir prophylaxis in HBsAg positive liver transplantation candidates. Hepatology 2007; 46: 479A.
Hadziyannis S, Tassopoulos N, Chang TT. Long-term adefovir dipivoxil treatment induces regression of liver fibrosis in patients with HBeAg-negative chronic hepatitis B: Results after 5 years of therapy [Abstract]. Hepatology 2005; 42: 754A.
Borroto-Esoda K, Arterburn S, Snow A. Final analysis of the virological outcomes and resistance during 5 years of adefovir dipivoxil monotherapy in HBeAg-negative patients. J Hepatol 2006; 44: S179-S180.
Colonno RJ, Rose RE, Pokornowski. Assessment at three years shows high barrier to resistance is maintained in entecavir-treated nucleoside naive patients while resistance emergence increases over time in lamivudine refractory patients. Hepatology 2006; 44: 229A-230A.
Powell JJ, Apiratpracha W, Partovi N, Erb SR, Scudamore CH, Steinbrecher UP, Buczkowski AK, et al. Subcutaneous administration of hepatitis B immune globulin in combination with lamivudine following orthotopic liver transplantation: effective prophylaxis against recurrence. Clin Transplant 2006; 20: 524-5.