Hepatitis B is a viral infection that attacks the liver and can lead to serious diseases, such as cirrhosis and liver cancer. Using livers from deceased donors infected with hepatitis B may expand the donor pool. But this may cause risks for recipients.
Previous studies have demonstrated that the livers can be safe if recipients receive proper prophylaxis treatments to prevent new-onset hepatitis B. There are several methods to do this, but which one is the best remains unknown.
Now, a novel study shows that a prophylaxis treatment can prevent new-onset hepatitis B in children who receive liver transplants from donors that previously infected with HBV but had successfully cleared the virus.
In the study, the researchers describe their prophylaxis treatment and characterize the long-term outcome of 41 pediatric recipients of livers from donors previously infected with hepatitis B. The treatment consisted of HBV vaccine intramuscular injections given intermittently to maintain antibody levels against a hepatitis B protein above 100 IU/L. Hepatitis B immunoglobulin--which is prepared from the plasma of donors who have high levels of such antibodies--was also used during the first post-transplant year, and it was given to maintain a target antibody level above 200 IU/L. Only one case (2.4 percent) of new-onset hepatitis B occurred over a median follow-up period of 66 months post-transplant.
life-long monitoring of HBV status is necessary in these patients, because new-onset hepatitis B may occur long after transplantation.
The new treatment is safe to use and patients require less than one injection per year on average. Moreover, it's effective and inexpensive. All the advantages of the treatment make it a better fit for pediatric liver transplant recipients.
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