|Title:||The Ways Paved for Prophylaxis against De Novo Hepatitis B Virus Infection after Liver Transplantation : Still Many Stones Left Unturned||Authors:||NI, YEN-HSUAN
|Keywords:||hepatitis B virus;liver transplantation;prophylaxis||Issue Date:||2006||Journal Volume:||v.10||Journal Issue:||n.4||Start page/Pages:||405-407||Source:||PEDIATRIC TRANSPLANTATION||Abstract:||
After solid organ transplantation, the recipients are usually unable to mount an adequate immune response as effectively as normal subjects because of the use of immunosuppressive agents (1). Waning immunity and impaired de novo anti-body response amy cause impaired protection after solid organ transplantation. For those with inadequate immunity to hepatitis B virus (HBV), it is a common practice to immunize the patients against HBV infection when they are put on the transplantation waiting list and post- transplan-tation, although the vaccination is not always successful in patients with HBV-related cirrhosis (2,3). The prophylaxis against HBV infection for liver transplantation recipients is focused on two parts: (a) For those transplanted for HBV-related diseases: low-dose hepatitis B immuno-globulin (HBIG) and/or antiviral agent(s) are the two agents used for the prophylaxis againstreinfection of the allograft. The strategy has generally reached a consensus (4 ). (b) For the prevention of de novo HBV infection in those transplanted for non-HBV-related diseases: there are no well -established guidelines and this is the primary goal of the study conducted by Kwon et al. (5) published in this issue of the Journal. Kwon et al. analyzed the favorable factors for the development of an adequate anti-HBs response in patients after liver transplantation and concluded that active immunization could achieve an acceptable efficacy for an average of 3 yr. The same Korean group previously reported the successful immune response to HBV vaccine in children after liver transplantation (6). They adapted a protocol of passive immuniza-tion ( HBIG) immediately after transplantation plus an active immunization subsequently if an anti-HBc positive graft was used. This protocol did not completely prevent the occurrence of de novo HBV infection because two of the 14 patients with anti-HBc donors developed de novo HBV infection. prophylaxis against HBV infection for liver transplantation recipients is focused on two parts
|Appears in Collections:||醫學系|
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