[Comprehensive prophylaxis and treatment of hepatitis B recurrence after liver transplantation]

The outcome of liver transplantation for end-stage liver disease secondary to hepatitis B is remarkably impacted by recurrent infection and subsequent allograft failure. Pre-operational viral replication, immunosuppression degree, and disease types play an important role in hepatitis B recurrence. This article summarizes the mechanisms, the influencing factors, and clinical diagnosis for recurrence of hepatitis B following liver transplantation, and discusses multiple strategies to prevent hepatitis B recurrence. Lamivudine in combination with low-dose hepatitis B immuno-globulin currently is the most effective therapy to prevent recurrent hepatitis B virus allograft infection. It is emphasized that effective prophylaxis approaches against hepatitis B virus recurrence should be adopted before, during, and after operation. Long-term and even life-long antiviral therapy is important for a better outcome.