Review article: hepatitis B and liver transplantation

Area of Science:

• Hepatology
• Virology
• Transplant Surgery

Background:

• Liver transplantation is a vital treatment for hepatitis B virus (HBV)-related liver failure and cancer.
• Significant advancements in antiviral prophylaxis have drastically improved graft and patient survival rates over the last decade.

Purpose of the Study:

• To evaluate the impact of modern antiviral therapies on outcomes in liver transplantation for HBV patients.
• To discuss strategies for preventing and managing HBV graft re-infection and de novo infection.

Main Methods:

• Review of outcomes data for liver transplantation in HBV patients.
• Analysis of the efficacy of antiviral prophylaxis regimens, including lamivudine and adefovir.
• Examination of strategies for managing HBV graft infection post-transplantation.

Main Results:

• Liver transplantation outcomes for HBV are now superior to many other indications.
• Lamivudine combined with passive immunoprophylaxis effectively prevents re-infection in most cases.
• Combination nucleoside analogue therapy is effective for established HBV graft infection, achieving viral suppression and antigen clearance.

Conclusions:

• Modern antiviral prophylaxis and treatment have transformed liver transplantation outcomes for HBV patients.
• Vigilant monitoring and combination therapy are crucial for managing HBV recurrence and ensuring long-term graft and patient survival.