关键词: 肝移植 , 乙型病毒性肝炎 , 复发 , 危险因素

Abstract:

Objective The aim of this study was to determine the risk factors associated with the recurrenceof hepatitis B virus infection after liver transplantation related to the recipients. Methods Clinical data of 320 consecutive patients who had history of Hepatitis B and underwent liver transplantation in Beijing Chaoyang Hospital from 2013 to 2019 were retrospectively collected，followed and analyzed. The data which are probableinformation related to the recurrence of hepatitis B in the perioperative period were organized and analyzed. ResultsAmong the 320 patients, 178 patients had hepatic malignant tumor caused by hepatitis B，84 patients experienced liver failure caused by hepatitis B and 58 patients had decompensated liver cirrhosis. Recurrence of hepatitis B was diagnosed in 25 patients at the end of the follow-up date with an incidence rate of 7.8%. The mean duration of recurrence was 19.7 months. The 1-，3- and 5-year recurrence rate after surgery were 3.0%，10.5% and 11.5%. The 1-，3- and 5-year recurrence rate of hepatitis B of patients with benign liver disease and patients withhepatic malignant tumor were 0%，3.9%，3.9% and 5.5%，16.6%，18.6%（P ＝ 0.001）respectively. Multivariate analysis showed that the causes of primary disease（RR ＝ 3.639，95%CI ：1.138 ~ 11.637），replications amountof HBV DNA（RR ＝ 2.180，95%CI ：1.362 ~ 3.489）and the history of hepatitis B treatment（RR ＝ 6.011，95%CI ：1.769 ~ 20.421）were the independent risk factors which affect the recurrence of hepatitis B after livertransplantation. Conclusion The primary disease，the activity level of hepatitis B replication and the antiviral treatment before surgery are associated with the recurrence of hepatitis B after liver transplantation. The recipients with malignant liver tumor，higher HBV DNA replication and without any antiviral treatment had a higher risk of hepatitis B recurrence after liver transplantation. 

Key words: Liver transplantation, Viral hepatitis B, Recurrence, Risk factors