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MINERVA GASTROENTEROLOGICA E DIETOLOGICA

A Journal on Gastroenterology, Nutrition and Dietetics


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Minerva Gastroenterologica e Dietologica 2017 Nov 10

DOI: 10.23736/S1121-421X.17.02453-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Hepatitis B and liver transplantation

Alberto FERRARESE 1, Alberto ZANETTO 1, Francesco P. RUSSO 2

1 Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy; 2 Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy


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Liver transplantation (LT) is the only effective treatment for hepatitis B-virus (HBV) related end stage liver disease, even if the outcome of these patients, has significantly improved after introduction of effective and well tolerated nucleos/tide analogues (NUC). Pre-transplant therapy has been initially based on lamivudine, but entecavir and tenofovir represent the currently recommended first-line therapeutic option in patients with HBV decompensated cirrhosis. After LT, the development of hepatitis B immunoglobulin (HBIG) in the early 1990s change dramatically the prognosis of these patients by reducing the incidence of HBV recurrence and increasing survival rate. Combination of HBIG and NUC is now considered as the standard of care for prophylaxis against HBV recurrence, however personalized therapeutic algorithms based on pre and post-transplant viral and host factors have been proposed. Finally, liver grafts from hepatitis B core antibody (anti-HBc) positive donors and from hepatitis B antigens (HBsAg) positive donors can be safely used in selected patients.


KEY WORDS: HBV - Liver transplantation - Acute-on-chronic liver failure - HCC - Antiviral therapy

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Publication History

Article first published online: November 10, 2017
Manuscript accepted: November 7, 2017
Manuscript received: November 1, 2017

Cite this article as

Ferrarese A, Zanetto A, Russo FP. Hepatitis B and liver transplantation. Minerva Gastroenterol Dietol 2017 Nov 10. DOI: 10.23736/S1121-421X.17.02453-9

Corresponding author e-mail

francescopaolo.russo@unipd.it