BACKGROUND: Prophylaxis of hepatitis B after liver transplantation with antiviral(s) and immunoglobulins efficiently protect the majority of recipients; however recent experiences suggest a decline of HBsag-positive candidates and the use of hepatitis B immunoglobulin-free schedules. MetHoDs: this national survey evaluated the epidemiology and clinical results of hepatitis B prophylaxis among 10,365 liver transplants performed in 25 years in 13 italian centers. RESULTSː With a percentage of 22, 2260 procedures were performed in HBsAg-positive recipients and 714 out of 1080 anti-HBc-positive grafts were used in HBsag-negative recipients; a total of 2974 patients (29%) were considered at risk of hepatitis B after liver transplantation. similar rates (18% of HBsag-positive candidates and 15% of anti-HBc-positive grafts) were registered in the last collected year. combined prophylaxis with Hepatitis B immunoglobulins remained prevalent among centers and was effective in 96% of HBsag-positive recipients and in 94% of HBsag-negative recipi-ents of anti-HBc-positive grafts.CONCLUSIONS: Data from this survey confirm: the excellent results of combined prophylaxis; the past and persistent use of Hepatitis B immunoglobulin-on and only rare -off prophylactic regimens, in contrast with the newest reports; the increasing use of anti-HBc-positive grafts; the past and present high prevalence of HBsag-positive recipients, due to an increase in candidates with either hepatocellular carcinoma and Hepatitis Delta Virus coinfection in the last years.

Prevalent use of Combined Prophylaxis of Hepatitis B after liver transplantation in Italy: Results of a national survey in a large cohort / Marzano, Alfredo; Andreone, Pietro; Boccagni, Patrizia; Burra, Patrizia; Caneschi, Francesco; Conoscitore, Pasquale F.; Coppola, Carmine; De Carlis, Luciano; Fagiuoli, Stefano; Forte, Paolo; Gaeta, Giovanni B.; Iemmolo, Rosa M.; Suffredini, Anna Lotti; Mazzola, Michele; Merli, Manuela; Parrilli, Gianpaolo; Piai, Guido; Piras, Maria R.; Salizzoni, Mauro; Tamè, Mariarosa; Tisone, Giuseppe; Toniutto, Pierluigi; Vennarecci, Giovanni; Volpes, Riccardo; Zamboni, Fausto; Caccamo, Lucio; Bertuzzo, Valentina R.; Bongiovanni, Assunta S.; Brin-Dicci, Gaetano; Cocchis, Donatella; Ettorre, Giuseppe M.; Gianni, Elena; Giusto, Michela; Lenisa, Ilaria; Lucà, Maria G.; Mameli, Laura; Mangoni, Iacopo; Manini, Matteo A.; Paoli, Serena; Russo, Francesco P.; Staiano, Laura; Stornaiuolo, Gianfranca; Toti, Luca; Valente, Giovanna; Vukotic, Ranka. - In: MINERVA GASTROENTEROLOGICA E DIETOLOGICA. - ISSN 1121-421X. - 64:1(2018), pp. 1-9. [10.23736/s1121-421X.17.02407-2]

Prevalent use of Combined Prophylaxis of Hepatitis B after liver transplantation in Italy: Results of a national survey in a large cohort

Merli, Manuela;Giusto, Michela;
2018

Abstract

BACKGROUND: Prophylaxis of hepatitis B after liver transplantation with antiviral(s) and immunoglobulins efficiently protect the majority of recipients; however recent experiences suggest a decline of HBsag-positive candidates and the use of hepatitis B immunoglobulin-free schedules. MetHoDs: this national survey evaluated the epidemiology and clinical results of hepatitis B prophylaxis among 10,365 liver transplants performed in 25 years in 13 italian centers. RESULTSː With a percentage of 22, 2260 procedures were performed in HBsAg-positive recipients and 714 out of 1080 anti-HBc-positive grafts were used in HBsag-negative recipients; a total of 2974 patients (29%) were considered at risk of hepatitis B after liver transplantation. similar rates (18% of HBsag-positive candidates and 15% of anti-HBc-positive grafts) were registered in the last collected year. combined prophylaxis with Hepatitis B immunoglobulins remained prevalent among centers and was effective in 96% of HBsag-positive recipients and in 94% of HBsag-negative recipi-ents of anti-HBc-positive grafts.CONCLUSIONS: Data from this survey confirm: the excellent results of combined prophylaxis; the past and persistent use of Hepatitis B immunoglobulin-on and only rare -off prophylactic regimens, in contrast with the newest reports; the increasing use of anti-HBc-positive grafts; the past and present high prevalence of HBsag-positive recipients, due to an increase in candidates with either hepatocellular carcinoma and Hepatitis Delta Virus coinfection in the last years.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11573/1068434
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