Outcomes of liver transplantation for hepatitis B: A single-center study of 35 patients

A. Benner, E. Lyden, J. Rogge, L. Weaver, Sandeep Mukherjee

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Results of liver transplantation (LT) for hepatitis B (HBV) have improved in the past decade but recently drug resistance has been described, the clinical significance of which is unclear. The aims of this study were to evaluate outcomes of LT for HBV and describe the prevalence of drug resistance. A retrospective chart analysis and review of the organ transplant database was performed to identify all patients transplanted for HBV between December 1982 and April 2004 who survived more than 3 months. Thirty-five patients were transplanted for HBV during this period: 27 men and 8 women. Median age at LT was 48.8 years (range 18.9 to 74.3). Four patients were transplanted for fulminant liver failure and 31 for decompensated cirrhosis. Intramuscular HBIG was administered to 8 patients and intravenous HBIG to 32 patients, data were unavailable for three patients. Lamivudine was prescribed for 18 patients (58%) pre-OLT and for 31 patients (88.6%) post-LT. Drug-resistant HBV developed in two patients (5.71%) receiving lamivudine and HBIG. Adefovir substitution resulted in improvement in liver function tests, in HBV DNA and in histology in both patients. Twenty-five patients are currently alive with and 1-year survival of 95% and a 5-year survival of 75%. Causes of death were respiratory failure (n = 3), metastatic cancer of unknown primary (n = 2), renal failure (n = 2), sepsis (n = 1), cerebrovascular accident (n = 1), and cerebral edema (n = 1). LT for HBV shows survival rates comparable to other liver transplant recipients. Lamivudine resistance was rare in this series but responded to adefovir substitution.

Original languageEnglish
Pages (from-to)2741-2743
Number of pages3
JournalTransplantation Proceedings
Volume36
Issue number9
DOIs
StatePublished - Nov 2004
Externally publishedYes

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Hepatitis B
Liver Transplantation
Lamivudine
Drug Resistance
Survival
Acute Liver Failure
Liver Function Tests
Brain Edema
Respiratory Insufficiency
Renal Insufficiency
Cause of Death
Sepsis
Histology
Fibrosis
Survival Rate
Stroke
Databases
Transplants
Liver
DNA

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

Cite this

Outcomes of liver transplantation for hepatitis B : A single-center study of 35 patients. / Benner, A.; Lyden, E.; Rogge, J.; Weaver, L.; Mukherjee, Sandeep.

In: Transplantation Proceedings, Vol. 36, No. 9, 11.2004, p. 2741-2743.

Research output: Contribution to journalReview article

Benner, A. ; Lyden, E. ; Rogge, J. ; Weaver, L. ; Mukherjee, Sandeep. / Outcomes of liver transplantation for hepatitis B : A single-center study of 35 patients. In: Transplantation Proceedings. 2004 ; Vol. 36, No. 9. pp. 2741-2743.
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abstract = "Results of liver transplantation (LT) for hepatitis B (HBV) have improved in the past decade but recently drug resistance has been described, the clinical significance of which is unclear. The aims of this study were to evaluate outcomes of LT for HBV and describe the prevalence of drug resistance. A retrospective chart analysis and review of the organ transplant database was performed to identify all patients transplanted for HBV between December 1982 and April 2004 who survived more than 3 months. Thirty-five patients were transplanted for HBV during this period: 27 men and 8 women. Median age at LT was 48.8 years (range 18.9 to 74.3). Four patients were transplanted for fulminant liver failure and 31 for decompensated cirrhosis. Intramuscular HBIG was administered to 8 patients and intravenous HBIG to 32 patients, data were unavailable for three patients. Lamivudine was prescribed for 18 patients (58{\%}) pre-OLT and for 31 patients (88.6{\%}) post-LT. Drug-resistant HBV developed in two patients (5.71{\%}) receiving lamivudine and HBIG. Adefovir substitution resulted in improvement in liver function tests, in HBV DNA and in histology in both patients. Twenty-five patients are currently alive with and 1-year survival of 95{\%} and a 5-year survival of 75{\%}. Causes of death were respiratory failure (n = 3), metastatic cancer of unknown primary (n = 2), renal failure (n = 2), sepsis (n = 1), cerebrovascular accident (n = 1), and cerebral edema (n = 1). LT for HBV shows survival rates comparable to other liver transplant recipients. Lamivudine resistance was rare in this series but responded to adefovir substitution.",
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