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Review article: preventing hepatitis B graft infection in hepatitis B patients after liver transplantation: immunoglobulin vs anti-virals

Review article: preventing hepatitis B graft infection in hepatitis B patients after liver transplantation: immunoglobulin vs anti-virals

Authors :
Vijay Gayam
Calvin Q. Pan
James S. Park
Source :
Alimentary Pharmacology & Therapeutics.
Publication Year :
2020
Publisher :
Wiley, 2020.

Abstract

Background A critical aspect of liver transplantation in hepatitis B patients is to prevent graft reinfection with hepatitis B virus. The use of hepatitis B immune globulin after transplant was a significant milestone, which allowed prolonged graft and patient survival by controlling hepatitis B reinfection in liver grafts. The development of anti-viral treatments with oral nucleos(t)ide analogues, led to a further reduction in graft reinfection and improvement in patient survival. The combination of the aforementioned two therapies has been widely used in hepatitis B-associated liver transplants. Aims To address the post-transplant management of hepatitis B and provide updates on preventing graft reinfection. Methods We performed a literature search on Ovid and PubMed for randomised controlled trials or cohort studies in English, which investigated the effectiveness of hepatitis B immune globulin and anti-viral therapy on hepatitis B-associated transplants (1/2000-1/2020). Studies that met pre-established criteria were reviewed. Results Based on currently available evidence, an algorithm for post-transplant management with anti-viral therapy is proposed. Also, the management of recipients who received grafts from hepatitis B core antibody-positive donors is discussed. Conclusions The development of hepatitis B immune globulin and anti-viral treatments led to substantial improvement in graft and patient survival. The prevention of hepatitis B graft reinfection is complex and involves a broad interdisciplinary team.

Details

ISSN :
02692813
Database :
OpenAIRE
Journal :
Alimentary Pharmacology & Therapeutics
Accession number :
edsair.doi.dedup.....41179ba0355690703b66005957f6b942
Full Text :
https://doi.org/10.1111/apt.15999