Abstract:

Objective To compare the clinical effects of different regimens for prophylaxis of hepatitis B recurrence post liver transplantation in different times of a single center，summarize and optimize the treatment protocol. Methods Nine hundred and eighty-four adult patients diagnosed as hepatitis B related end stage benignliver diseases underwent primary liver transplant between May 1994 and December 2012，of whom 62 recipients died within 30 days after transplantation and were not included for statistical analysis. The remaining 922 patients were grouped as non-treatment，famciclovir，lamivudine and nucleos（t）ide analogues combined with hepatitis Bimmune globulin（HBIG）group based on 4 different regimens for prophylaxis of hepatitis B recurrence post liver transplantation. Results Hepatitis B recurrence occurred in 27 patients. Among them，all the 3 patients of non-treatment group（underwent transplant between 1994-1999）showed recurrence，all the 2 patients in famciclovir group （underwent transplant between 1998-1999）showed recurrence，6 patients（40.0%）in lamivudine group（underwenttransplant between 1998-2001）showed recurrence，and 16 patients（1.8%）in nucleos（t）ide analogues combined with HBIG group（underwent transplant between 1999-2012）showed recurrence. Both cumulative hepatitis B recurrence rates（χ2 ＝ 48.99，P ＝ 0.000）and cumulative patient survival rates（χ2 ＝ 62.694，P ＝ 0.000）showed significant statistical significance among these four groups of patients. Conclusion With the successful development and widespread marketing of nucleos（t）ide analogues and HBIG，regimens for prophylaxis of hepatitis B recurrence after liver transplantation have been optimized gradually in our center. Nucleos（t）ide analogues combinedwith HBIG was proved effective，and has been applicated by many other centers throughout our whole country，which provides strong support for the outcomes of liver transplantation in HBV-related end stage liver diseases.