Abstract:

Objective To investigate the effect of Lamivudine and Hepatitis B Vaccine onpreventing de novo hepatitis B virus （HBV）infection in recipients with anti-HBc-positive grafts in pediatric liver transplantation Methods A total number of 251 pediatric recipients receiving HBcAb positive grafts operated from May 2016 to December 2019 were retrospectively enrolled, Donor and recipient features along with graft and recipient outcomes were compared between recipients treated with Lamivudine and Hepatitis B Vaccine. Results Lamivudine group（45 cases）and Hepatitis B Vaccine Group（206 cases）showed no significant difference in clinical characteristics. The number of de novo hepatitis B virus infection was 5 cases（11.1%）and 10 cases（4.9%）, respectively, the incidence was not statistically significant between two groups（P ＝ 0.075）.There was a correlation between the discontinuation of Lamivudine and the de novo Hepatitis B. Conclusion Lamivudine alone and Hepatitis B vaccine are effective prophylactic strategies for preventing de novo HBV infection inpediatric liver transplantation recipients who receive hepatitis B core antibody（HBcAb）positive grafts. Discontinuing Lamivudine increases the risk of de novo hepatitis B virus infection.

Key words: Pediatric liver transplantation, HBV infection, HBcAb positive donor, Lamivudine, Hepatitis B vaccine

摘要：

目的 比较拉米呋定与乙肝疫苗方案预防乙型肝炎核心抗体（hepatitis B core antibody，HBcAb）阳性供肝儿童肝移植术后新发乙型肝炎病毒（hepatitis B virus，HBV）感染效果。方法 对天津市第一中心医院自 2013 年 5 月— 2019 年 6 月 251 例接受 HBcAb 阳性供肝儿童肝移植的资料进行回顾性分析，依据采用预防方案的不同分为拉米呋定组和乙肝疫苗组，对两组患儿的新发乙肝病毒感染情况以及临床资料进行比较分析。结果 拉米呋定组 45 例和乙肝疫苗组 206 例，两组在供受者的临床特征方面无显著差异，两组的新发乙肝病毒感染例数分别为 5 例（11.1%）和 10 例（4.9%），发生率无显著统计意义（P ＝ 0.075），停用拉米呋定与新发乙肝存在关系。结论 单用拉米呋定和乙肝疫苗均是有效预防 HBcAb 阳性供肝术后新发乙肝的方案，停用拉米呋定会增加新发乙肝的风险。

关键词: 儿童肝移植 , 乙肝病毒感染 , HBcAb 阳性供体 , 拉米呋定 , 乙肝疫苗