Liver - Original Article

Role of nucleoside/nucleotide analogues and low-dose hepatitis B immune globulin in prophylaxis of hepatitis B recurrence among cadaveric liver transplant recipients

Volume 29 · Issue 1 Publish Date: January 15, 2018
Tokunbo Ajayi Harry Luu Behnam Saberi James P. Hamilton Bugra Tolga Konduk Burak Özşeker Kawtar Al Khalloufi Aliaksei Pustavoitau Benjamin Philosophe Andrew M. Cameron Ahmet Gürakar
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Turkish Journal of Gastroenterology

Volume 29 · Issue 1

Pages: 61-66

History

Published Online: January 15, 2018

Copyright © 2018 Tokunbo Ajayi, Harry Luu, Behnam Saberi, James P. Hamilton, Bugra Tolga Konduk, Burak Özşeker, Kawtar Al Khalloufi, Aliaksei Pustavoitau, Benjamin Philosophe, Andrew M. Cameron, Ahmet Gürakar

Tokunbo Ajayi
Department of Internal Medicine, Johns Hopkins Howard County General Hospital, Columbia, MD; Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD.
Harry Luu
Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD
Behnam Saberi
Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD.
James P. Hamilton
Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD.
Bugra Tolga Konduk
Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD
Burak Özşeker
Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD.
Kawtar Al Khalloufi
Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD.
Aliaksei Pustavoitau
Department of Anesthesiology and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD.
Benjamin Philosophe
Transplant Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Andrew M. Cameron
Department of Surgery, Transplant Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
Ahmet Gürakar
Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD.
Ajayi, T., Luu, H., Saberi, B., Hamilton, J. P., Konduk, B. T., Özşeker B., … Gürakar A. (2018). Role of nucleoside/nucleotide analogues and low-dose hepatitis B immune globulin in prophylaxis of hepatitis B recurrence among cadaveric liver transplant recipients. Turkish Journal of Gastroenterology, 29(1), 61–66. https://doi.org/10.5152/tjg.2018.17595
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Abstract

Abstract Background/Aims: Hepatitis B core antibody (HBcAb) positivity of the donor or the recipient may pose a risk of hepatitis B virus (HBV) reactivation following liver transplantation (LT). We retrospectively investigated patient survival and reactivation among recipients who were given low-dose Hepatitis B Immune Globulin (HBIG) plus antiviral agent (AV) versus AV only. Materials and Methods: Records of cadaveric LT recipients, between 2013 and 2016, with positive Hepatitis B surface Antigen (HBsAg) and/or HBcAb and recipients who had received LT from HBcAb-positive donors were reviewed. Patient characteristics and clinical data were extracted. Donor variables were retrieved from the United Network of Organ Sharing (UNOS) database. HBIG (1560 IU/mL) Intravenous (IV) was intraoperatively administered with three daily doses. Entecavir 1 mg daily was also given. STATA was used for statistical analysis. Results: There were 53 recipients; 39 (73.6%) were male with a median age of 59 y. HCV was the major indication in 30 (55.6%) patients. There were 28 recipients (52.8%) who received HBIG plus AV and 25 (47.2%) received AV only. The Model of End Stage Liver Disease (MELD) score between the groups were similar. Survival rates at 6, 12, and 24 months were 100% (n=53), 93.2% (n=44), and 100.0% (n=26), respectively. There was no reactivation; two recipients in the AV group and one in the HBIG plus AV group died within 12 months. Conclusion: This study supports the use of low-dose HBIG and AV for post-LT prophylaxis to be as effective as conventionally used high-dose HBIG (9600 IU) plus AV. Future prospective larger studies are warranted to examine the potential benefits of using AV alone without HBIG. Cite this article as: Ajayi T, Luu H, Saberi B, et al. Role of nucleoside/nucleotide analogues and low-dose hepatitis B immune globulin in prophylaxis of hepatitis B recurrence among cadaveric liver transplant recipients. Turk J Gastroenterol 2018; 29: 58-63.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 29 · Issue 1
Pages 61-66
DOI 10.5152/tjg.2018.17595
History
Published Online January 15, 2018
Copyright
Copyright (c) 2018 Tokunbo Ajayi, Harry Luu, Behnam Saberi, James P. Hamilton, Bugra Tolga Konduk, Burak Özşeker, Kawtar Al Khalloufi, Aliaksei Pustavoitau, Benjamin Philosophe, Andrew M. Cameron, Ahmet Gürakar
Affiliations
Tokunbo Ajayi
Department of Internal Medicine, Johns Hopkins Howard County General Hospital, Columbia, MD; Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD.
Harry Luu
Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD
Behnam Saberi
Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD.
James P. Hamilton
Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD.
Bugra Tolga Konduk
Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD
Burak Özşeker
Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD.
Kawtar Al Khalloufi
Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD.
Aliaksei Pustavoitau
Department of Anesthesiology and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD.
Benjamin Philosophe
Transplant Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Andrew M. Cameron
Department of Surgery, Transplant Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
Ahmet Gürakar
Division of Gastroenterology and Hepatology, Transplant Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD.
Cite this Article
Ajayi, T., Luu, H., Saberi, B., Hamilton, J. P., Konduk, B. T., Özşeker B., … Gürakar A. (2018). Role of nucleoside/nucleotide analogues and low-dose hepatitis B immune globulin in prophylaxis of hepatitis B recurrence among cadaveric liver transplant recipients. Turkish Journal of Gastroenterology, 29(1), 61–66. https://doi.org/10.5152/tjg.2018.17595
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