NDLI: Twenty-four year single-center experience of hepatitis B virus infection in heart transplantation.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Chen, Y. C. Chuang, M. K. Chou, N. K. Chi, N. H. Wu, I. H. Chen, Y. S. Yu, H. Y. Huang, S. C. Wang, C. H. Tsao, C. I. Ko, W. J. Wang, S. S.
Spatial Coverage	Taiwan
Description	Country affiliation: Taiwan Author Affiliation: Chen YC ( Department of Surgery, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan.)
Abstract	OBJECTIVE: Hepatitis B virus (HBV) infection is hyperendemic in Taiwan. We have reported the outcome of (1) recipients with hepatitis B surface antigen (HBsAg)-positive; HBsAg-negative recipients who receive donor hearts from HBsAg-positive donors; and treatment with lamivudine of hepatitis B flare-ups after heart transplantation, using case numbers that range from 100 to 200. METHODS: From July 1987 to May 2011, all 412 orthotopic heart transplant recipients and donors underwent routine preoperative screening for hepatitis B virus markers and liver function parameters. Lamivudine was prescribed prophylactically for recipients with elevated serum enzyme levels or an HBV DNA virus load before transplantation, or when there was evidence of hepatitis B flare-up after transplantation. Postoperative HBV markers and liver function parameters were collected over a mean follow-up time of 7.8 years. RESULTS: Thirty-four recipients were HBsAg-positive before heart transplantation, and 23 experiencing HBV reactivation upon follow-up requiring lamivudine treatment. Clinical responses were achieved in all of them: 15 were complete and two, slow partial responses. Twenty-six recipients with an HBV naïve status at the time of heart transplantation, and three patients received donor hearts from an HBsAg-positive donor under perioperative hepatitis B immunoglobulin prophylaxis. HBV infection was successfully prevented in two patients, but the other one contracted HBV hepatitis, which was successfully treated with lamivudine. CONCLUSIONS: HBV reactivation after the heart transplantation was common but usually well controlled with lamivudine treatment. Although posttransplantation liver function deteriorated for a period, there was no HBV infection-related morbidity or mortality. Perioperative hepatitis B immunoglobulin prophylaxis can successfully prevent HBV naïve recipients from infection in some cases, but HBsAg-positive donors should only be considered in high risk situations.
File Format	HTM / HTML
ISSN	00411345
Issue Number	4
Volume Number	44
e-ISSN	18732623
Journal	Transplantation Proceedings
Language	English
Publisher	Elsevier
Publisher Date	2012-05-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Transplantation__semicolon__medicine Heart Failure Surgery Heart Transplantation Hepatitis B Complications Adult Alanine Transaminase Blood Antiviral Agents Therapeutic Use Biological Markers Dna, Viral Donor Selection Female Adverse Effects Diagnosis Drug Therapy Prevention & Control Hepatitis B Surface Antigens Hepatitis B Virus Genetics Immunology Humans Immunoglobulins Immunosuppressive Agents Lamivudine Male Middle Aged Retrospective Studies Taiwan Time Factors Treatment Outcome Viral Load Virus Activation Young Adult Journal Article
Content Type	Text
Resource Type	Article
Subject	Transplantation Surgery

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