Liver,biliary tract,pancreas,spleen

209178 Long-term prevention of virus recurrence among recipients with HBV active replication following liver transplantation/Dai Jun(Liver Transplant Center,West Chin Hosp,Sichuan Univ,Chengdu 610041)…∥Chin J Hepatobil Surg.-2009,15(2).-106~109Objective To investigate the long-term prophylactic outcome in recipierts with HBV active replication under LAM or/and HBIG prophylaxis after liver transplantation.Methods The liver biopsy specimens and serum samples were collected during the follow-up.ELISA and chemiluminesent microparticle immunoassay,HBV-DNA fluorescent quantification,immunohistochemisty and HBV-DNA in situ hybridization were performed for analysis.The alteratio of HBV markers in serial biopsy and sera of 55 recipients were investigated retrospectively.Results The mean time of follow-up was 69.14 months.Twelve cases had hepatitis B virus reinfection after transplantation.The accumulated ratio of hepatitis B virus reinfection was 4.8%(2/42)in LAM+HBIG group and 76.9%(10/13) in LAM monoprophylaxis group(P=0.000).The 1-,2-,3-and 4-yr,survival rates in combined prophylaxis group were 100%,97.1%,92.7% and 92.7%,respectively.The 1-,2-,3-and 4-yr survival rates in LAM mono prophylaxis group were 76.9%,69.2%,53.8% and 46.2%,respectively(P=0.000).The rates of hepatitis B virus reinfection in combination prophylaxis group(1-,2-,3-and 4-yr recurrence rates of 2.4%,2.4%,2.4%,and 8.5%,respectively) was markedly lower than those in mono prophylaxis group(1-,2-,3-and 4-yr recurrence rates of 16.1%,41.3%,66.4% and 66.4%,respectively)(P=0.000).Conclusion Currently HBIG combined with LAM is an optimal prophylatic protocol to reduce the hepatitis B virus reifection rate.However,poor compliance of recipients to a prescribed course of prophylaxis as well as viral staus itself is still the main cause of hepatitis B virus reinfection after liver transplantation in China.Compliance education and adjusting the prophylatic protocols according to the viral alteration after liver transplantation may help to further decrease the hepatitis B virus reinfection rate.17 refs,4 tabs.