Details

Autor(en) / Beteiligte

• Togashi, Junichi
• Akamatsu, Nobuhisa
• Sugawara, Yasuhiko
• Kaneko, Junichi
• Tamura, Sumihito
• Tanaka, Tomohiro
• Arita, Junichi
• Sakamoto, Yoshihiro
• Hasegawa, Kiyoshi
• Kokudo, Norihiro

Titel

One-year extended, monthly vaccination prophylaxis combined with hepatitis B immune globulin for hepatitis B after liver transplantation

Ist Teil von

• Hepatology research, 2016-03, Vol.46 (3), p.E51-E59

Ort / Verlag

Netherlands: Blackwell Publishing Ltd

Erscheinungsjahr

2016

Link zum Volltext

Quelle

Wiley Online Library All Journals

Beschreibungen/Notizen

• Aim The feasibility of vaccination in liver transplant recipients is highly controversial, and the present study aimed to investigate the efficacy of a 1‐year extended, monthly vaccine prophylaxis protocol of a second‐generation recombinant vaccine for transplant recipients. Methods The recombinant hepatitis B vaccine (10 µg) was administrated s.c. every month for 12 months as the vaccination protocol to 39 liver transplant recipients in stable condition, including those with hepatitis B‐related chronic liver disease (n = 30), those with acute hepatitis B liver failure (hepatitis B surface antibody [HBsAb], n = 4), and those with hepatitis B core antibody positive grafts (n = 5). A fixed dose of hepatitis B immune globulin (HBIG) was administrated during the study based on the monoprophylaxis approach, and the increase in the hepatitis B surface antibody titer was measured to evaluate the efficacy of the vaccination. Results The vaccination protocol was initiated a mean of 54 months (range, 13–124) after liver transplantation, and all patients tolerated the vaccination well without adverse effects. The overall hepatitis B virus (HBV) recurrence rate was 5% (2/39) based on hepatitis B surface antigen positivity, and 2% (1/39) based on HBV DNA detectability. Six (15%) patients showed a good response to vaccination with an increase in the HBsAb titer greater than 100 IU/L at the end of vaccination, but only three (8%) maintained an adequate HBsAb level to spare HBIG during the 2‐year observation period. Conclusion While a few patients demonstrated an adequate response to vaccination, the clinical indication for the HBV vaccination for liver transplant recipients is currently minimal.