Anti-parietal cell autoantibodies (PCA) in primary biliary cirrhosis: a putative marker for recurrence after orthotopic liver transplantation? Ciesek S, et al. Efficacy of maintenance subcutaneous hepatitis B immune globulin (HBIG) post-transplant for prophylaxis against hepatitis B recurrence. Singham, et al. Throughout most of its history, primary biliary cirrhosis (PBC) and chronic hepatitis B (HBV) , were considered the “yin and yang” of indications for liver transplantations. Transplantation was considered virtually curative for the former disease and, until the mid-1990s, the latter was considered futile and an absolute contraindication for transplantation due to a very high incidence of graft re-infection resulting in poor outcomes. Needless to say, much has changed since the early days of transplantation. Graft recurrence of primary biliary cirrhosis is a well-recognized phenomenon that usually occurs late post-transplant and is typically mild, although graft loss can rarely occur. With the introduction of passive immunization with hepatitis B immune globulin (HBIG), liver transplantation has become very feasible for those suffering from HBV. Initially most centers employed protocols requiring high dose intravenous HBIG, however, the development of relatively effective antiviral agents has allowed for the use of combination prophylaxis protocols utilizing low dose intramuscular HBIG in combination with oral antiviral agents. The low dose intramuscular HBIG protocols were an improvement in prophylaxis delivery that became more convenient, albeit sometimes painful, for patients and easier for the post-transplant clinic nursing staff. Today, liver transplant recipients undergoing transplantation for PBC and HBV enjoy excellent post-transplant outcomes.
2010-05-31 | 492 visitas | Evalua este artículo 0 valoraciones
Vol. 9 Núm.2. Abril-Junio 2010 Pags. 117-119 Ann Hepatol 2010; 9(2)