[Prophylaxis and therapy of hepatitis B after liver transplantation]

About 25% of all liver transplantations in USA are performed for liver disease due to viral hepatitis, 25% of them related to hepatitis B. It is also known that 90%-100% of transplanted persons with proven replicative stage of hepatitis B [HBeAg (+), HBV DNA (+)] develop reinfection of the transplanted liver in the absence of prophylaxis. This percentage is lower (30%-50%) in patients with nonreplicative stage of infection [HBeAg (-), HBV DNA (-)]. The consequence of most transplant infections is death due to the transplanted organ failure. The prophylaxis of infection is possible, however a combination of intravenous hepatitis B hyperimmune gammaglobulin and lamivudin may be too expensive for some transplantation centers in less developed countries. The aim of this article is to recommend prophylaxis and treatment of recurrent hepatitis B in persons with transplanted liver using data of the Consensus Conference on Hepatitis B in Geneva 2002, Canadian Consensus Group for Hepatitis (CASL) and EASL International Consensus Conference on Hepatitis B that should be available for patients in Croatia.