Management of Hepatitis B Virus Infection in Liver Transplantation Setting; The Rising Concerns and Growing Hopes, Report From 10th Congress of the Iranian Society for Organ Transplantation, 2011, Shiraz, Iran

authors:

avatar Seyed Moayed Alavian ORCID 1 , * , avatar Kamran B. Lankarani 2 , avatar Mario Rizzetto 3 , avatar Alfredo Marzano 4 , avatar Mohsen Moghadami 5 , avatar Saman Nik-Eghbolian 6 , avatar Amin Bahrani 6

Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, alavian@thc.ir, IR Iran
Health Policy Research Center, Shiraz University of Medical Sciences, IR Iran
Department of Gastroenterology, Molinette University of Torino, Italy
Division of Gastroenterology and Hepatology, San Giovanni Battista Hospital, Italy
HIV/AIDS Research Center, Shiraz University of Medical Sciences, IR Iran
Shiraz Organ Transplant Unit, Namazee Hospital, Shiraz University of Medical Sciences, IR Iran
Hepatitis Monthly: Vol.12, issue 12; 8094
published online: December 30, 2012
article type: Meeting Report
received: August 1, 2012
accepted: September 8, 2012
DOI: https://doi.org/10.5812/hepatmon.8094

how to cite: Alavian S M, B. Lankarani K , Rizzetto M , Marzano A , Moghadami M , et al. Management of Hepatitis B Virus Infection in Liver Transplantation Setting; The Rising Concerns and Growing Hopes, Report From 10th Congress of the Iranian Society for Organ Transplantation, 2011, Shiraz, Iran. Hepat Mon. 2012;12(12):8094. https://doi.org/10.5812/hepatmon.8094.

Abstract

Hepatitis B infection is the main cause of liver related mortality in many countries including Iran. Liver transplantation in cirrhosis due to HBV infection before 1990 was an absolute contraindication. Recurrent infection was a significant event in post liver transplant setting and resulted in increased risk of graft failure and death except successful transplanted individuals. Advances in antiviral prophylaxis have now made graft reinfection majority patients as a rare event. Graft and patient survival have been improved significantly during the past two decades, and consequences of transplantation for hepatitis B virus are now superior to those achieved for most other indications. This has encouraged many centers including the major liver transplantation center of Iran, in Shiraz, to provide liver transplantation to more patients with HBV related end stage liver disease. Management of these patients begins before transplantation along with special care after transplantation. There are some myths and doubts in the management of these patients and one should always balance the cost and efficiency. One of the major concerns is the high economic and social cost of recurrence and all possible efforts should be performed to avoid the ominous consequences of reinfection. Having a clear scientific grasp on the management of HBV cirrhosis before and after liver transplantation, options and protocols, and changing the concept which HBV infected are contraindicated ones for liver transplantation, and future hopes in increasing patients survival after liver transplantation using the new nucleosides analogues and availability of hepatitis B immunoglobulin in the transplantation setting. This scientific report paper outlines the insights communicated at the HBV and liver transplantation symposium during 10th Congress of the Iranian Society for Organ Transplantation, May 2011, Shiraz, Iran.

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