Hepatitis B core antibody (anti-HBc)-positive allografts are sometimes used for patients requiring urgent orthotopic liver transplantation, because of a shortage of more suitable donors.
Anti-HBc-positive allografts transmit hepatitis B at a high rate, so effective prophylaxis is required.
Dr Andy Yu and colleagues investigated the effectiveness of lamivudine therapy in preventing hepatitis B infection.
15 of 169 patients requiring orthotopic liver transplantation, at the Cedars-Sinai Medical Center in Los Angeles, USA, received liver allografts from anti-HBc-positive donors.
|Anti-HBc-positive allografts can be used.
Of these 15 patients, 6 were hepatitis B surface antigen-positive, and 9 hepatitis B surface antigen-negative before liver transplantation.
All patients received oral lamivudine at a dose of 100 or 150 mg per day, following liver transplantation.
Patients who were hepatitis B surface antigen-positive before transplantation also received hepatitis B immunoglobulin prophylaxis (HBIG).
After a mean follow-up of 20 months, all 15 patients remained negative for hepatitis B surface antigen.
Dr Yu concluded, "Anti-HBc-positive allografts can be safely used if prophylaxis with combination HBIG and lamivudine, or lamivudine monotherapy, is administered after transplantation."
However, Dr Yu stresses the need for more data to confirm the efficacy of lamivudine monotherapy.