Langenbeck's Archives of Surgery

, Volume 397, Issue 5, pp 697–710

The role of HBIg as hepatitis B reinfection prophylaxis following liver transplantation

Authors

    • Department of General, Visceral and Transplantation SurgeryUniversity of Heidelberg
  • Majid Esmaeilzadeh
    • Department of General, Visceral and Transplantation SurgeryUniversity of Heidelberg
  • Hamidreza Fonouni
    • Department of General, Visceral and Transplantation SurgeryUniversity of Heidelberg
  • Mohammadreza Hafezi
    • Department of General, Visceral and Transplantation SurgeryUniversity of Heidelberg
  • Nuh N. Rahbari
    • Department of General, Visceral and Transplantation SurgeryUniversity of Heidelberg
  • Mohammad Golriz
    • Department of General, Visceral and Transplantation SurgeryUniversity of Heidelberg
  • Ali Majlesara
    • Department of General, Visceral and Transplantation SurgeryUniversity of Heidelberg
  • Morva Tahmasbi Rad
    • Department of General, Visceral and Transplantation SurgeryUniversity of Heidelberg
  • Mahmoud Sadeghi
    • Department of Transplantation ImmunologyUniversity of Heidelberg
  • Jan Schmidt
    • Department of General, Visceral and Transplantation SurgeryUniversity of Heidelberg
  • Tom M. Ganten
    • Department of Gastroenterology, Hepatology and Infectious DiseasesUniversity of Heidelberg
Review Article

DOI: 10.1007/s00423-011-0795-6

Cite this article as:
Mehrabi, A., Esmaeilzadeh, M., Fonouni, H. et al. Langenbecks Arch Surg (2012) 397: 697. doi:10.1007/s00423-011-0795-6

Abstract

Background and introduction

Without adequate prophylaxis, liver transplantation (LTx) is frequently followed by hepatitis B virus (HBV) reinfection, which results in rapidly progressing liver disease and significantly decreased overall survival. In the last two decades, significant progress has been made in the prophylaxis and treatment of HBV.

Discussion

We present an overview of different protocols and regimens used for prophylaxis of HBV reinfection after LTx and describe the protocol implemented at our center. Following LTx, HBV reinfection can be effectively prevented by administration of anti-hepatitis B immunoglobulin (HBIg) alone or more recently in combination with antiviral nucleoside/nucleotide analogs (NUCs). Several studies reported good results with the use of HBIg alone, but combination treatment with HBIg and NUCs has proven to be a superior prophylactic regimen for HBV recurrence. At present, combination therapy (HBIg and a nucleoside or nucleotide analog) is the gold standard used in many transplantation centers. This preventive regimen reduces the risk of a recurrence of HBV infection and thereby the need for re-transplantation. Future and ongoing studies will show how long HBIg must be given after transplantation, especially when used in combination with potent antivirals, such as entecavir or tenofovir.

Keywords

HBIgHepatitis B virusProphylaxisLiver transplantationNucleoside/nucleotide analogs

Copyright information

© Springer-Verlag 2011