Short-term high-dose followed by long-term low-dose hepatitis B immunoglobulin and lamivudine therapy prevented recurrent hepatitis B after liver transplantation
Short-term high-dose followed by long-term low-dose hepatitis B immunoglobulin and lamivudine therapy prevented recurrent hepatitis B after liver transplantation
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DOI：
10.1097/01.tp.0000246310.75638.86
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发表时间：
2007-01-27
期刊：
影响因子：
6.2
通讯作者：
Shiratori, Yasushi
中科院分区：
文献类型：
--
作者：
Takaki, Akinobu;Yagi, Takahito;Shiratori, Yasushi
B型肝炎免疫球蛋白（HBIg）联合拉米夫定已被公认为控制肝移植术后B型肝炎复发的最佳方法。然而，HBIg的最佳剂量和B型肝炎表面抗体（HBIAb）的目标滴度仍不清楚。我们报告了我们在早期使用高剂量HBIg，随后使用低剂量HBIg和拉米夫定的令人满意的经验。受试者包括5例暴发性肝炎（FH）和18例肝硬化（LC）患者接受肝移植。术后给予HBIg 200 IU/kg/d，共1周。此后，仅在抗HBIAb滴度< 100 IU/L时给予HBIg。6个月后，FH患者停用HBIg，LC仅在HBIAb滴度< 10 IU/L时给予HBIg。两例FH和所有LC病例均给予拉米夫定治疗。尽管2例LC患者出现一过性B型肝炎表面抗原（HBsAg）复发，但所有患者在最终随访时HBsAg均为阴性。这种方法可以可靠和成本效益的控制B型肝炎复发。
Hepatitis B immunoglobulin (HBIg) and lamivudine combination has been accepted as the best way to control hepatitis B recurrence after liver transplantation. However, the optimal dose of HBIg and the target titer of hepatitis B surface antibody (HBsAb) remain unclear. We report our satisfactory experience with high-dose HBIg in the early period followed by low-dose HBIg with lamivudine. Subjects comprised five patients with fulminant hepatitis (FH) and 18 patients with liver cirrhosis (LC) who underwent liver transplantation. HBIg at a dosage of 200 IU/kg per day was administered for one week postoperatively. Thereafter, HBIg was administered only for HBsAb titer < 100 IU/L. After six months, HBIg was withdrawn in FH and administered in LC only for HBsAb titer < 10 IU/L. Lamivudine was administered to two FH and all LC cases. Although two patients with LC showed transient hepatitis B surface antigen (HBsAg) recurrence, all patients remained HBsAg-negative at the final follow-up date. This method allows reliable and cost-effective control of hepatitis B recurrence.