PITTSBURGH, Nov. 5 -- Livers from hepatitis B positive donors were safely transplanted and a combination drug treatment prevented infection in recipients of those livers, a University of Pittsburgh Medical Center (UPMC) researcher will report at the 49th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD) in Chicago Nov. 6-10. The results of the preliminary study are among more than 30 presentations by UPMC researchers, including three singled out by the AASLD for their scientific merits and study design.
In the face of a chronic shortage of organ donors, surgeons must often consider transplanting organs that may be considered less optimal or high risk. For example, if the only option available to save a patient's life is to transplant a liver from a donor who tests positive for hepatitis B (anti-HBc positive), a surgeon may do so even if it places the recipient at an increased risk for becoming infected with the virus. Post-transplant hepatitis B infection, which is usually evident within six months, is difficult to treat and can eventually lead to cirrhosis of the transplanted liver, thus requiring a second transplant.
But according to the UPMC study, a combination therapy of hepatitis B
immune globulin (HBIG) and lamivudine has the potential to stave off
post-transplant infection in patients not immune to hepatitis B who receive
hepatitis B positive livers. Twelve patients who received the combination
therapy, which started during the transplant operation and continued for 18
months, all continue to be free of infection between five and 25 months
post-transplant, according to the study's lead author, Andrew Bonham, M.D.,
assistant professor of surgery at the Thomas E. Starzl Transplantation
Institute. Four of these patients, who were ICU-bound before their transplants,
had never been exposed to hepatitis (anti-HBs negative) and had no immunity to
the virus (anti-HBc negative). Eight others, mo
Contact: Lisa Rossi
University of Pittsburgh Medical Center