Liver transplantation for patients with hepatitis B virus-related diseases

To summarize the results of the orthotopic liver transplantation (OLT) for HBV-related diseases and assess the efficiency of lamivudine on preventing HBV recurrence.

From April 1993 to December 2000, 54 patients with HBV-related liver disease were treated by OLT at the Transplantation Center of Sun Yet-sen University of Medical Sciences (SUMS). Seventeen patients who had postnecrotic cirrhosis (PNC) as a result of HBV infection were designated as group 1; 25 patients coexisting hepatocellular carcinoma (HCC) served as group 2; the remaining 12 patients who had no liver disease but fulminant hepatic failure (FHF) due to HBV infection served as group 3. The survival rate, the causes of early death and the HBV recurrence rate under lamivudine monotherapy were retrospectively analyzed.

The overall survival rate within 2 months of transplantation was 75.9% and the morbidity in group 3 was obviously higher than in group 1 and group 2; the outcome patients with small HCC was superior to that of patients with large HCC; lamivudine monotherapy can effectively prevent and treat HBV recurrence while no side effect attributable to it had been identified.

Combined with the use of lamivudine, liver transplantation can be justified in patients with fulminant hepatitis B, hepatitis B-related liver cirrhosis and coexisting small HCC or even selected large HCC.