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논문 기본 정보

자료유형
학술저널
저자정보
Kyeong Deok Kim (Department of Surgery Samsung Medical Center Sungkyunkwan University School of Medicine) Ji Eun Lee (Department of Radiology Soonchunhyang University Bucheon Hospital) 김종만 (삼성서울병원) Okjoo Lee (Department of Surgery Samsung Medical Center Sungkyunkwan University School of Medicine) Na Young Hwang (Statistics and Data Center Research Institute for Future Medicine Samsung Medical Center) Jinsoo Rhu (Department of Surgery Samsung Medical Center Sungkyunkwan University School of Medicine) Gyu-Seong Choi (Department of Surgery Samsung Medical Center Sungkyunkwan University School of Medicine) Kyunga Kim (Statistics and Data Center Research Institute for Future Medicine Samsung Medical Center Seoul) Jae Won Joh (Sungkyunkwan University)
저널정보
대한간학회 Clinical and Molecular Hepatology Clinical and Molecular Hepatology 제27권 제4호
발행연도
2021.10
수록면
603 - 615 (13page)
DOI
10.3350/cmh.2021.0137

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Background/Aims: Hepatitis B core antibody (anti-HBc)-positive donors are used as an extended donor pool, and current guidelines recommend the usage of nucleos(t)ide analogues (NAs) as prophylaxis for preventing de novo hepatitis B virus infection (DNH). We analyzed the long-term outcomes of a large cohort of liver transplantation (LT) patients receiving anti-HBc-positive grafts and evaluated the risk of DNH when hepatitis B immunoglobulin (HBIG) monotherapy was used as prophylaxis. We also compared the cost-effectiveness of HBIG and NAs. Methods: We retrospectively reviewed 457 patients with anti-HBc-positive grafts and 898 patients with anti-HBcnegative grafts who underwent LT between January 2001 and December 2018. We compared recipient characteristics according to the anti-HBc status of the donor, and compared the costs of using NAs for the rest of the patient’s life and using HBIG to maintain hepatitis B surface antibody titers above 200 IU/L. Results: The 1-, 5-, and 10-year patient survival rates were 87.7%, 73.5%, and 67.7%, respectively, in patients with anti- HBc-positive grafts, and 88.5%, 77.4%, and 70.3%, respectively, in patients with anti-HBc-negative grafts (P=0.113). Among 457 recipients with anti-HBc-positive grafts, 117 (25.6%) were non-HBV recipients. The overall incidence of DNH was 0.9%. When using HBIG under insurance coverage, the cumulative cost was lower compared with using NA continuously without insurance coverage in Korea. Conclusions: Anti-HBc-positive grafts alone do not affect patient survival or graft survival. HBIG monoprophylaxis has good outcomes for preventing DNH, and the patient’s long-term cost burden is low in Korea because of the national insurance system in this cohort.
#Liver transplantation #Hepatitis B virus #Hepatitis B core antibody #De novo hepatitis B virus #Hepatitis B immunoglobulin

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참고문헌 (23)

참고문헌 신청
Chazouillères O / 1994 / "Occult" hepatitis B virus as source of infection in liver transplant recipients / Lancet 343:142~146 google schola Dickson RC / 1997 / Transmission of hepatitis B by transplantation of livers from donors positive for antibody to hepatitis B core antigen. The National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database / Gastroenterology 113:1668~1674 google schola Takemura N / 2007 / Liver transplantation using hepatitis B core antibody-positive grafts : review and university of Tokyo experience / Dig Dis Sci 52:2472~2477 google schola Korean Association for the Study of the Liver (KASL) / 2019 / KASL clinical practice guidelines for management of chronic hepatitis B / Clinical and Molecular Hepatology 25(2):93~159 google schola Lee KW / 2004 / Prevention of de novo hepatitis B infection from HbcAb-positive donors in living donor liver transplantation / Transplant Proc 36:2311~2312 google schola

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