Hepatitis B Liver Transplant | Medical Algorithm

Description

Patients with hepatitis B viral infection may have disease recurrence after orthotopic liver transplantation. Certain factors favor recurrence, while others factors reduce the risk. The immunosuppression required to prevent rejection can favor infection once initiated.

Parameter	Finding	Effect on Risk for Recurrence
reason for transplant	cirrhosis	increase
	fulminant hepatic failure	decrease
	retransplantation for graft failure due to recurrent HBV infection	increase
viral coinfection (HCV and/or HDV)	present	neutral
	absent	increase
high replicative status (HbeAg or HBV DNA) prior to transplant	present	increase
	absent	neutral
antiviral therapy with transplantation	high dose HBIG (hepatitis B immune globulin)	decrease
	lamivudine, other antiviral agents	decrease

Patients with recurrent HBV infection after transplantation tend to have a worse survival than other patients undergoing liver transplantation.

The use of immune globulin in combination with antiviral agents has markedly improved the prognosis of patients with HBV undergoing liver transplantation.

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Description

Specialty

Objective

ICD-10

Prediction of Hepatitis B Virus Recurrence After Orthotopic Liver Transplantation

Purpose: To identify a transplant candidate with hepatitis B viral infection at risk for recurrence after liver transplantation.

Description

Specialty

Objective

ICD-10