Active Immunization to Prevent De Novo Hepatitis B Virus Infection in Pediatric

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Active Immunization to Prevent De Novo Hepatitis B Virus Infection in

Pediatric Live Donor Liver Recipients

Authors: Lin, C.-C.1; Chen, C.-L.; Concejero, A.1; Wang, C.-C.1; Wang,

S.-H.1; Liu, Y.-W.1; Yang, C.-H.1; Yong, C.-C.1; Lin, T.-S.1; Jawan, B.2;

Cheng, Y.-F.3; Eng, H.-L.4

Source: American Journal of Transplantation, Volume 7, Number 1, January

2007, pp. 195-200(6)

Publisher: Blackwell Publishing

Abstract:

This study aims to evaluate the efficacy of HBV vaccination as an

alternative preventive measure against de novo HBV infection in pediatric

living donor liver transplantation (LDLT). Sixty recipients were enrolled in

this study. Thirty received grafts from anti-HBc(+) donors, and another 30

received grafts from anti-HBc( & #8722;) donors. HBV vaccine was given

pretransplant to every candidate. Posttransplant, lamivudine was routinely

given to recipients receiving anti-HBc(+) grafts for about 2 years.

Forty-seven (78%) recipients achieved high levels of anti-HBs titer (>1000

IU/L). Two (3.3%) recipients developed de novo HBV infection where one

received an anti-HBc( & #8722;) graft and another received an anti-HBc(+)

graft. Both recipients were in the lower anti-HBs titer group (<1000 IU/L).

The incidence of de novo HBV infection was significantly higher in the lower

titer group (15.4% vs. 0%, p = 0.04). The median follow-up period was 51

months in recipients with anti-HBc( & #8722;) grafts and 57 months in those

with anti-HBc(+) grafts. Active immunization is an effective method to

prevent de novo HBV infection. It can result in high levels of anti-HBs

titer (>1000 IU/L) which may prevent de novo HBV infection in pediatric

patients with efficient primary vaccination undergoing LDLT.

DOI: 10.1111/j.1600-6143.2006.01618.x

Affiliations: 1: Departments of Surgery and Liver Transplantation Program 2:

Anesthesiology and Liver Transplantation Program 3: Diagnostic Radiology and

Liver Transplantation Program 4: Pathology and Liver Transplantation

Program, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung,

Taiwan

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