Abstract:
BACKGROUND:A combination of hepatitis B immunoglobulin and nucleos(t)ide analogues is the current standard of care for controlling hepatitis B recurrence after orthotopic liver transplantation (OLT). However, frequent immunoglobulin treatment is expensive and inconvenient. This study investigated the efficacy of hepatitis B virus (HBV) vaccination in preventing the recurrence of hepatitis B after living donor OLT. METHODS:Twenty-seven patients who had undergone living donor OLT participated in the study; five had acute HBV infected liver failure (ALF-OLT) and 22 had HBV related liver cirrhosis (LC-OLT). Hepatitis B surface antigen (HBsAg)-containing vaccine was administered to them for at least 1 year after transplantation and continued once monthly for up to 36 months post-OLT. Patients who had anti-HBs antibody titers above 100 mIU/mL for a minimum of 6 months without immunoglobulin administration were defined as good responders; the others were defined as poor responders. Interferon-γ enzyme-linked immunospot assays against HBs and HBc antigens were used to assay cellular immune responses. RESULTS:All five of the ALF-OLT patients had good responses after a median of four (range 2.5-5) vaccinations. Nine of the 22 LC-OLT patients had good responses after a median of 19 (range 11.5-30) vaccinations. Among the LC-OLT group, those with livers donated by relatively higher-aged, marital and high-titer anti-HBs antibody donors were good responders. LC-OLT patients classed as good responders showed interferon-γ responses comparable to those of the ALF-OLT patients. CONCLUSIONS:The ALF-OLT and LC-OLT patients who received livers from relatively higher-aged, marital, high-titer anti-HBs antibody donors were the best candidates for HBV vaccine administration. Boosting donors before transplantation may facilitate later vaccine response of the recipients.
journal_name
J Gastroenteroljournal_title
Journal of gastroenterologyauthors
Takaki A,Yagi T,Yasunaka T,Sadamori H,Shinoura S,Umeda Y,Yoshida R,Sato D,Nobuoka D,Utsumi M,Yasuda Y,Nakayama E,Miyake Y,Ikeda F,Shiraha H,Nouso K,Fujiwara T,Yamamoto Kdoi
10.1007/s00535-013-0763-8subject
Has Abstractpub_date
2013-12-01 00:00:00pages
1373-83issue
12eissn
0944-1174issn
1435-5922journal_volume
48pub_type
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