Related Experiment Videos
Should liver transplantation be performed for patients with chronic hepatitis B? Yes!
1Department of Medicine, University of California, San Francisco, USA.
Insights
Patients with chronic hepatitis B can now undergo successful liver transplantation. Passive immunoprophylaxis effectively prevents hepatitis B virus (HBV) reinfection of the allograft, improving patient outcomes.
Area of Science:
- Hepatology
- Transplantation Immunology
Background:
- Chronic hepatitis B (CHB) was historically a contraindication for liver transplantation due to high rates of post-transplant viral recurrence.
- Hepatitis B virus (HBV) reinfection of the liver allograft significantly impairs long-term graft survival and patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of passive immunoprophylaxis in preventing HBV recurrence after liver transplantation.
- To advocate for the inclusion of CHB patients as suitable candidates for liver transplantation.
Main Methods:
- Administration of passive immunoprophylaxis (e.g., hepatitis B immune globulin) to prevent HBV reinfection.
- Analysis of patient outcomes and allograft survival following liver transplantation for CHB.
Main Results:
- Passive immunoprophylaxis has dramatically improved outcomes for liver transplant recipients with CHB.
- HBV reinfection can be prevented in nearly all patients, making CHB a favorable indication for transplantation.
- Liver transplantation is now considered a viable and effective treatment option for patients with chronic hepatitis B.
Conclusions:
- Liver transplantation is a highly successful treatment for patients with chronic hepatitis B.
- Passive immunoprophylaxis is a cost-effective strategy to prevent HBV recurrence post-transplantation.
- No patient with chronic hepatitis B should be denied liver transplantation based on serological status.
Abstract:
The use of passive immunoprophylaxis to prevent HBV reinfection of the allograft following liver transplantation has led to a dramatic improvement in the outcome of patients who undergo transplantation for chronic hepatitis B. Hepatitis B previously was not one of our favorite diseases for which to perform liver transplantation. However, we now regard patients with this disease as good candidates for liver transplantation. I hope I have presented a compelling argument that no patient with hepatitis B, regardless of serological status, should be a priori denied liver transplantation. Studies from both the U.S. and Europe have shown that HBV reinfection can be prevented in almost all patients at a cost not out of line with other accepted indications for liver transplantation. Thus, I once again, ask the question, "Should patients with chronic hepatitis B undergo liver transplantation?" At our institution, the answer is an emphatic Yes!