Resumen

MONCADA, Diana et al. Prevention of Hepatitis B Recurrence in Liver Transplant Recipients Using Low Doses of Anti-Hepatitis B Immunoglobulin and Nucleoside Analogue. Rev Col Gastroenterol [online]. 2017, vol.32, n.1, pp.1-6. ISSN 0120-9957.  https://doi.org/https://doi.org/10.22516/25007440.123.

Introduction: Hepatitis B results in one million deaths every year and is is an important reason for liver transplantation. The use of anti-hepatitis B immunoglobulin at high doses and nucleoside analogues have reduced reinfection of the graft by 90%. Objective: This study evaluated the efficacy of low doses of immunoglobulin to prevent reinfection of grafts after transplantation. Methodology: This is a retrospective study of a series of patients who had been transplanted and who received immunoglobulin after transplantation at the Hospital Pablo Tobón Uribe between January 2004 and September 2014. Hepatitis B viral load, transaminase and serological markers were used to document relapses. Other variables studied included mortality, complications, graft dysfunction, adverse reactions and costs. Results: There were 18 patients with hepatitis B who had transplants: 50% had hepatocarcinoma, 22% had cirrhosis, and 22% had acute liver failure. The median follow-up time was 43.27 months with a range of 14.7 to 65.2 months. Two patients tested positive for surface antigen in the post-transplant period and one relapsed and had a positive viral load at 41 months. The graft reinfection rate was 5.5%. There were no deaths. It was estimated that the cost of using low doses of immunoglobulin was lower than that of using high doses at 6 months of therapy, but no cost-effectiveness study was done. Graft dysfunction was 10% to 33 months. Conclusion: Low doses of immunoglobulin prevented reinfection of grafts in a way that is similar to that reported in other series. While immunoglobulin free schemes have proven to be useful for the long term, low doses of immunoglobulin remain useful.

Palabras clave : Liver transplantation; hepatitis B; immunoglobulin; antiviral.

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