肝移植术后乙肝复发的预防和治疗

Prevention and Treatment for Recurrence of Hepatitis B after Liver Transplantation

目的 探讨乙肝相关疾病患者肝移植术后乙型肝炎病毒 (HBV)再感染的防治。方法 复习有关文献并进行综述。结果 与HBV有关的急、慢性肝病是肝移植的主要适应证 ,但未作预防者移植后HBV再感染率可达80 %～ 10 0 % ,对移植肝的存活和患者的生存有重大的影响。如何防治肝移植后乙型肝炎的复发 ,成为急需解决的问题。经过一系列的摸索 ,目前已有许多用于防治HBV再感染的药物 ,包括抗乙肝免疫球蛋白、干扰素、核苷类似物等 ,其各自有不同的应用特点 ,在单独及联合用药方面也有了新的研究进展。结论 肝移植是治疗乙肝相关疾病的有效方法 ,围手术期的积极药物治疗 。

Objective To investigate the prevention and treatment for recurrence of hepatitis B after liver transplantation on HBV related diseases.Methods Making a literature summarization based on published papers review.Results Acute and chronic HBV related diseases are the main indications of liver transplantation.Recurrence rate of hepatitis B is from 80% to 100% in the untreated patients after liver transplantation,and it affects the survivals of patients seriously.It has become a focus to prevent and treat the recurrence of hepatitis B.After a series of explotation and application,there have been a lot of drugs of preventing and treating HBV reinfection, including hepatitis B immunoglobulin,interferon and nucleotide analog antivirus drugs(lamivudine, famcyclovir, adefovir),etc.The therapeutic characteristics of them are different. Their utilizations of dividing or alliance are developing rapidly Conclusion Liver transplatation is an effective therapy for HBV related disease. Anti HBV treatments perioperation play an important role in the improvement of succeed of liver transplantation.