HBV recurrence, despite immunoprophylaxis which occurred in 67% of our patients, remains the main problem following liver transplantation for HBV infection. Pretransplant viral replication (HBV-DNA) and probably viral mutation may account to some degree for the failures involved in hyperimmunoglobulin prophylaxis. In order to improve the cost/benefit relationship, only HBV-DNA and HBeAG-negative patients should be selected or preoperatively seroconverted by nucleosides (famciclovir, lamivudine); post-operatively a variable HIG prophylaxis should be administered.
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