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Conference Paper: Long-term outcomes of persistently positive hepatitis B surface antigen after liver transplantation for chronic hepatitis B
Title | Long-term outcomes of persistently positive hepatitis B surface antigen after liver transplantation for chronic hepatitis B |
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Authors | |
Issue Date | 2020 |
Publisher | Elsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep |
Citation | Digital International Liver Congress (Digital ILC 2020), 27-29 August 2020. In Journal of Hepatology, 2020, v. 73 n. Suppl. 1, p. S265-S266 How to Cite? |
Abstract | Background and Aims: Antiviral therapy alone without hepatitis B immune globulin (HBIG) has been shown to be effective after liver transplantation for chronic hepatitis B (CHB). However, a small
proportion will have persistently positive hepatitis B surface antigen (HBsAg), of which the long-term outcome is unclear. We aim to determine the long-term outcome of recipients with persistently positive HBsAg.
Method: Consecutive patients with CHB and liver transplantation from January 2003 to December 2017 were considered. All patients received HBIG-free regimen as prophylaxis with oral antiviral therapy alone. Graft survival and outcome were determined.
Results: A total of 630 CHB patients were transplanted, of which 582 (92%) had over one year of follow-up and were included. Of these, 486 (84%) were male, and 250 (43%), 212 (36%), and 120 (21%) were transplanted for decompensated cirrhosis, hepatocellular carcinoma (HCC), and severe flares respectively. The median follow-up was 104 months (range, 13–199). Forty-one (7%) had persistently positive HBsAg without evidence of seroclearance, with higher rates observed in severe flares compared to cirrhosis and HCC patients (13.3% vs. 6.8% vs. 3.8% respectively, p = 0.005). The graft survival for persistently positive HBsAg was 81.9%, 76.1% and 76.1% at 5, 10, and 15 years post-transplant respectively, compared to 93.1%, 85.3% and 77.3% respectively for those patients that were not persistently positive for HBsAg (p = 0.205), as shown in the figure. There were 9 graft losses during the follow up period for persistently positive HBsAg patients, of which 4 were due to HCC recurrence, 2 from lymphoma, 2 from extra-hepatic malignancies, and 1 from sepsis. There were no cases of graft loss due to de novo HCC or reactivation of hepatitis B virus infection. At the time of last follow-up, all active patients had undetectable HBV DNA.
Conclusion: Despite a persistently positive HBsAg after liver transplantation for CHB in patients receiving HBIG-free prophylaxis, there was excellent long-term graft survival, which was comparable to patients who had evidence of HBsAg loss. Importantly, there was no graft loss from de novo HCC or hepatitis B reactivation in persistently positive HBsAg patients. |
Description | Poster presentation - Liver transplantation and hepatobiliary surgery: Clinical aspects - no. THU254 |
Persistent Identifier | http://hdl.handle.net/10722/290215 |
ISSN | 2023 Impact Factor: 26.8 2023 SCImago Journal Rankings: 9.857 |
DC Field | Value | Language |
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dc.contributor.author | Fung, JYY | - |
dc.contributor.author | Chan, ACY | - |
dc.contributor.author | Wong, CLT | - |
dc.contributor.author | Dai, WC | - |
dc.contributor.author | Sin, SL | - |
dc.contributor.author | Mak, LY | - |
dc.contributor.author | Seto, WKW | - |
dc.contributor.author | Yuen, RMF | - |
dc.contributor.author | Lo, CM | - |
dc.date.accessioned | 2020-10-22T08:23:39Z | - |
dc.date.available | 2020-10-22T08:23:39Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Digital International Liver Congress (Digital ILC 2020), 27-29 August 2020. In Journal of Hepatology, 2020, v. 73 n. Suppl. 1, p. S265-S266 | - |
dc.identifier.issn | 0168-8278 | - |
dc.identifier.uri | http://hdl.handle.net/10722/290215 | - |
dc.description | Poster presentation - Liver transplantation and hepatobiliary surgery: Clinical aspects - no. THU254 | - |
dc.description.abstract | Background and Aims: Antiviral therapy alone without hepatitis B immune globulin (HBIG) has been shown to be effective after liver transplantation for chronic hepatitis B (CHB). However, a small proportion will have persistently positive hepatitis B surface antigen (HBsAg), of which the long-term outcome is unclear. We aim to determine the long-term outcome of recipients with persistently positive HBsAg. Method: Consecutive patients with CHB and liver transplantation from January 2003 to December 2017 were considered. All patients received HBIG-free regimen as prophylaxis with oral antiviral therapy alone. Graft survival and outcome were determined. Results: A total of 630 CHB patients were transplanted, of which 582 (92%) had over one year of follow-up and were included. Of these, 486 (84%) were male, and 250 (43%), 212 (36%), and 120 (21%) were transplanted for decompensated cirrhosis, hepatocellular carcinoma (HCC), and severe flares respectively. The median follow-up was 104 months (range, 13–199). Forty-one (7%) had persistently positive HBsAg without evidence of seroclearance, with higher rates observed in severe flares compared to cirrhosis and HCC patients (13.3% vs. 6.8% vs. 3.8% respectively, p = 0.005). The graft survival for persistently positive HBsAg was 81.9%, 76.1% and 76.1% at 5, 10, and 15 years post-transplant respectively, compared to 93.1%, 85.3% and 77.3% respectively for those patients that were not persistently positive for HBsAg (p = 0.205), as shown in the figure. There were 9 graft losses during the follow up period for persistently positive HBsAg patients, of which 4 were due to HCC recurrence, 2 from lymphoma, 2 from extra-hepatic malignancies, and 1 from sepsis. There were no cases of graft loss due to de novo HCC or reactivation of hepatitis B virus infection. At the time of last follow-up, all active patients had undetectable HBV DNA. Conclusion: Despite a persistently positive HBsAg after liver transplantation for CHB in patients receiving HBIG-free prophylaxis, there was excellent long-term graft survival, which was comparable to patients who had evidence of HBsAg loss. Importantly, there was no graft loss from de novo HCC or hepatitis B reactivation in persistently positive HBsAg patients. | - |
dc.language | eng | - |
dc.publisher | Elsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep | - |
dc.relation.ispartof | Journal of Hepatology | - |
dc.relation.ispartof | Digital International Liver Congress (Digital ILC 2020) | - |
dc.title | Long-term outcomes of persistently positive hepatitis B surface antigen after liver transplantation for chronic hepatitis B | - |
dc.type | Conference_Paper | - |
dc.identifier.email | Fung, JYY: jfung@hkucc.hku.hk | - |
dc.identifier.email | Chan, ACY: acchan@hku.hk | - |
dc.identifier.email | Wong, CLT: wongtcl@hku.hk | - |
dc.identifier.email | Dai, WC: daiwc@HKUCC-COM.hku.hk | - |
dc.identifier.email | Mak, LY: lungyi@hku.hk | - |
dc.identifier.email | Seto, WKW: wkseto@hku.hk | - |
dc.identifier.email | Yuen, RMF: mfyuen@hku.hk | - |
dc.identifier.email | Lo, CM: chungmlo@hkucc.hku.hk | - |
dc.identifier.authority | Fung, JYY=rp00518 | - |
dc.identifier.authority | Chan, ACY=rp00310 | - |
dc.identifier.authority | Wong, CLT=rp01679 | - |
dc.identifier.authority | Mak, LY=rp02668 | - |
dc.identifier.authority | Seto, WKW=rp01659 | - |
dc.identifier.authority | Yuen, RMF=rp00479 | - |
dc.identifier.authority | Lo, CM=rp00412 | - |
dc.description.nature | abstract | - |
dc.identifier.doi | 10.1016/S0168-8278(20)31034-5 | - |
dc.identifier.hkuros | 315876 | - |
dc.identifier.volume | 73 | - |
dc.identifier.issue | Suppl. 1 | - |
dc.identifier.spage | S265 | - |
dc.identifier.epage | S266 | - |
dc.publisher.place | Netherlands | - |
dc.identifier.issnl | 0168-8278 | - |