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Cited 4 time in webofscience Cited 5 time in scopus
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Hepatitis B Prophylaxis after Liver Transplantation in Korea: Analysis of the KOTRY Databaseopen access

Authors
Park, Gil-ChunHwang, ShinKim, Myoung-SooJung, Dong-HwanSong, Gi-WonLee, Kwang-WoongKim, Jong ManLee, Jae GeunRyu, Je HoChoi, Dong LakWang, Hee-JungKim, Bong-WanKim, Dong-SikNah, Yang WonYou, Young KyoungKang, Koo JeongYu, Hee ChulPark, Yo-HanLee, Kyung JinKim, Yun Kyu
Issue Date
Feb-2020
Publisher
대한의학회
Keywords
Hepatitis B Virus; Recurrence; Liver Transplantation; Hepatitis B Immunoglobulin; Antiviral Agent
Citation
Journal of Korean Medical Science, v.35, no.6
Indexed
SCIE
SCOPUS
KCI
Journal Title
Journal of Korean Medical Science
Volume
35
Number
6
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/28231
DOI
10.3346/jkms.2020.35.e36
ISSN
1011-8934
1598-6357
Abstract
Background: Prophylaxis for hepatitis B virus (HBV) recurrence is essential after liver transplantation (LT) in HBV-associated recipients. We conducted real-world analysis of HBV prophylaxis after LT in the Korean population. Methods: Korean Organ Transplantation Registry (KOTRY) database and additionally collected data (n = 326) were analyzed with special reference to types of HBV prophylaxis. Results: The study cohort comprised 267 cases of living-donor LT and 59 cases of deceased-donor LT. Hepatocellular carcinoma (HCC) was diagnosed in 232 (71.2%) of these subjects. Antiviral agents were used in 255 patients (78.2%) prior to LT. HBV DNA was undetectable in 69 cases (21.2%) and detectable over wide concentrations in the other 257 patients (78.8%) prior to LT. Polymerase chain reaction analysis of the store blood samples detected HBV DNA in all patients, with 159 patients (48.9%) showing concentrations > 100 IU/mL. Post-transplant HBV regimens during the first year included combination therapy in 196 (60.1%), hepatitis B immunoglobulin (HBIG) monotherapy in 121 (37.1%), and antiviral monotherapy in 9 (2.8%). In the second post-transplant year, these regimens had changed to combination therapy in 187 (57.4%), HBIG monotherapy in 112 (34.4%), and antiviral monotherapy in 27 (8.3%). Trough antibody to hepatitis B surface antigen titers > 500 IU/mL and >1,000 IU/mL were observed in 61.7% and 25.2%, respectively. The mean simulative half-life of HBIG was 21.6 +/- 4.3 days with a median 17.7 days. Up to 2-year follow-up period, HCC recurrence and HBV recurrence developed in 18 (5.5%) and 6 (1.8%), respectively. HCC recurrence developed in 3 of 6 patients with HBV recurrence. Conclusion: Combination therapy is the mainstay of HBV prophylaxis protocols in a majority of Korean LT centers, but HBIG was often administered excessively. Individualized optimization of HBIG treatments using SHL is necessary to adjust the HBIG infusion interval.
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Kim, Dong-Sik
Anam Hospital (Department of Hepato-Biliary-Pancreatic Surgery, Anam Hospital)
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