Purpose: The aim of this study was to investigate the safety and efficacy of lifelong therapy with intravenous hepatitis B immunoglobulins (i.v. HBIg) to prevent recurrence of hepatitis B after orthotopic liver transplantation (OLT).
Methods: This was a single-center retrospective study of the long-term outcome of 56 patients who were transplanted for active hepatitis B-related liver disease. In addition to i.v. HBIg, patients received antiviral therapy for at least 1 year.
Results: 1-, 5-, and 10-year survival rates were 95%, 82%, and 80%, respectively. None of the patients died due to hepatitis B virus (HBV)-related complications. In 3 patients (5%), a hepatitis B surface antigen (HBsAg)-negative status was not reached. All of these patients had a very high viral load at the time of OLT. HBsAg and HBV DNA reappeared in 6 patients (11%): In 1 patient, recurrence occurred 9 months after OLT while still under combination treatment with lamivudine, and 2 patients were temporarily treated abroad with intramuscular HBIg. Only 3 patients suffered from HBV recurrence while under monotherapy with i.v. HBIg. No serious side effects to i.v. HBIg were reported during this long-term follow-up.
Conclusion: Lifelong administration of i.v. HBIg is safe, and recurrence of HBV disease occurred only in a minority of the patients during long-term follow-up. Prognosis of HBV-related OLT with this therapy is excellent.
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