Liver transplantation for hepatitis B-related cirrhosis: recent advances

Sugawara, Yasuhiko; Makuuchi, Masatoshi

doi:10.1007/s00534-005-1077-x

Cited by 2 publications

(2 citation statements)

References 35 publications

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“…The authors found that the HBIG requirement was 38% lower in the combination group during the first 6 months, thus associated with a better costeffectiveness profile. The mechanisms contributing to lower HBIG requirement may involve LAMinduced decrease of viral replication leading to a lower production of HBsAg and thus to a lower rate of escape mutations in the pre-S, S and YMDD regions [76]. Shouval et al [77] recently presented their data regarding the antiviral effects, pharmacokinetics and safety of two new human monoclonal antiHBs antibodies (libivirumab/exbivirumab) as compared to HBIG in HBV liver transplant recipients.…”

Section: Prophylaxis Of Hepatitis B Recurrence After Liver Transplantmentioning

confidence: 99%

Hepatitis B and liver transplantation: 2008 update

Beckebaum

Sotiropoulos

Gerken

et al. 2008

Reviews in Medical Virology

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The ultimate goal of treatment is suppression of viral replication to undetectable HBV-DNA levels prior to and after liver transplantation (LT) to prevent infection of the newly transplanted liver. Most published data are available from therapy with lamivudine (LAM) in pre- and post-transplant HBV patients. Add-on therapy with adefovir dipivoxil (ADV) in pre-transplant LAM-resistant patients has been shown to represent an effective antiviral strategy leading to hepatic recompensation in many cases and, eventually, removal from the waiting list. Newer nucleos(t)ide analogues such as entecavir, tenofovir and telbivudine have shown lower resistance rates than LAM and more antiviral potency in studies in the non-transplant setting. Combined hepatitis B immune globulin (HBIG) and nucleos(t)ide analogue therapy have been widely adopted as the most effective treatment strategy against recurrent HBV disease after LT. Many programs have evaluated lower doses or a shorter duration of HBIG and intramuscular versus intravenous routes of administration. Active immunisation using recombinant HBV vaccines, including the S, pre-S1 and pre-S2 regions, and those with immunostimulatory adjuvants, seem to be more immunogenic than the currently available vaccines and have been used in studies to replace HBIG. Furthermore, it has been shown that immune memory against HBV can be adoptively transferred from organ donors to transplant recipients. Nucleos(t)ide analogue combination therapies might provide an alternative to the current treatment paradigm with costly HBIG; however, experience with this new treatment regimen is very limited and controlled clinical studies are urgently warranted to investigate its safety and efficacy and to determine which nucleos(t)ide analogue combinations will be the most promising in the long term after LT.

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Section: Prophylaxis Of Hepatitis B Recurrence After Liver Transplantmentioning

confidence: 99%

Hepatitis B and liver transplantation: 2008 update

Beckebaum

Sotiropoulos

Gerken

et al. 2008

Reviews in Medical Virology

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“…Cirrhosis is characterized by diffuse destruction of liver parenchymal cells accompanied with an increase of fibrous tissue has resulting disorganization of lobular and vascular architecture [1]. While liver transplantation is performed worldwide [], most patients with cirrhosis can not undergo transplantation because of insufficient numbers of donors, or exclusion on the basis of their understanding disease process.…”

Section: Introductionmentioning

confidence: 99%