• 第四軍醫(yī)大學(xué)西京醫(yī)院肝膽外科(西安710032);

目的 　探討乙型肝炎病毒(HBV)相關(guān)疾病患者肝移植圍手術(shù)期HBV再感染的預(yù)防措施。
方法 　回顧近年相關(guān)文獻(xiàn)并進(jìn)行綜述。
結(jié)果 　對(duì)患HBV相關(guān)的急、慢性肝病的肝移植患者，預(yù)防移植后HBV再感染至關(guān)重要。目前不僅有多種預(yù)防HBV再感染的藥物應(yīng)用于臨床，而且針對(duì)患者不同特點(diǎn)，在預(yù)防方案方面也有新的研究進(jìn)展。
結(jié)論 　肝移植是治療HBV相關(guān)疾病的有效方法，圍手術(shù)期合理準(zhǔn)確地選擇預(yù)防HBV再感染方案對(duì)延長患者肝移植術(shù)后存活期有重要意義。

引用本文： 張寧,竇科峰. 肝移植圍手術(shù)期HBV再感染的預(yù)防. 中國普外基礎(chǔ)與臨床雜志, 2007, 14(6): 735-738. doi: 復(fù)制

1. 　Steinmuller T, Seehofer D, Rayes N, et al. Increasing applicability of liver transplantation for patients with hepatitis B-related liver disease [J]. Hepatology, 2002; 35(6)∶1528.
2. 　Yao FY, Terrault NA, Freise C, et al. Lamivudine treatment is beneficial in patients with severely decompensated cirrhosis and actively replicating hepatitis B infection awaiting liver transplantation: a comparative study using a matched, untreated cohort [J]. Hepatology, 2001; 34(2)∶411.
3. 　Perrillo RP, Wright T, Rakela J, et al. A multicenter United States-Canadian trial to assess lamivudine monotherapy before and after liver transplantation for chronic hepatitis B [J]. Hepatology, 2001; 33(2)∶424.
4. 　Villeneuve JP, Condreay LD, Willems B, et al. Lamivudine treatment for decompensated cirrhosis resulting from chronic hepatitis B [J]. Hepatology, 2000; 31(1)∶207.
5. 　Lo CM, Cheung ST, Lai CL, et al. Liver transplantation in Asian patients with chronic hepatitis B using lamivudine prophylaxis [J]. Ann Surg, 2001; 233(2)∶276.
6. 　Perillo RP. Potential importance of the sexual transmission of non-A, non-B hepatitis [J]. Hepatology, 1991; 13(4)∶805.
7. 　Fontana RJ, Hann HW, Perrillo RP, et al. Determinants of early mortality in patients with decompensated chronic hepatitis B treated with antiviral therapy [J]. Gastroenterology, 2002; 123(3)∶719.
8. 　Peters MG, Hann Hw H, Martin P, et al. Adefovir dipivoxil alone or in combination with lamivudine in patients with lamivudine-resistant chronic hepatitis B [J]. Gastroenterology, 2004; 126(1)∶91.
9. 　Schiff ER, Lai CL, Hadziyannis S, et al. Adefovir dipivoxil therapy for lamivudine-resistant hepatitis B in pre- and post-liver transplantation patients [J]. Hepatology， 2003; 38(6)∶1419.
10. 　Villeneuve JP, Durantel D, Durantel S, et al. Selection of a hepatitis B virus strain resistant to adevir in a liver transplantation patient [J]. J Hepalo, 2003; 39(6)∶1085.
11. 　Yang H, Westland CE, Delaney WE 4th, et al. Resistance surveillance in chronic hepatitis B patients treated with adefovir dipivoxil for up to 60 weeks [J]. Hepatology， 2002; 36(2)∶464〖HJ*2〗12　Grellier L, Mutimer D, Ahmed M, et al. Lamivudine prophylaxis against reinfection in liver transplantation for hepatitis B cirrhosis [J]. Lancet， 1996; 348(9036)∶1212.
12. 　嚴(yán)茂林, 嚴(yán)律南， 李波， 等. 拉米夫定對(duì)肝移植術(shù)后乙肝病毒再感染的預(yù)防作用 [J]. 中國普外基礎(chǔ)與臨床雜志， 2006； 13（2）∶205.
13. 　Mutimer D, Pillay D, Shields P, et al. Outcome of lamivudine resistant hepatitis B virus infection in the liver transplant recipient [J]. Gut， 2000; 46(1)∶107.
14. 　Wai CT, Prabhakaran K, Wee A, et al. Adefovir dipivoxil as the rescue therapy for lamivudine-resistant hepatitis B post liver transplant [J]. Transplant Proc, 2004; 36(8)∶2313.
15. 　Palumbo E. Recent advances in the treatment of the hepatitis HBV-related. Effectiveness and tolerability of adefovir dipivoxil [J]. Recenti Prog Med, 2007; 98(4)∶237.
16. 　Barcena R, Del Campo S, Moraleda G, et al. Study on the efficacy and safety of adefovir dipivoxil treatment in post-liver transplant patients with hepatitis B virus infection and lamivudine-resistant hepatitis B virus [J]. Transplant Proc, 2005; 37(9)∶3960.
17. 　Yoshida H, Kato T, Levi DM, et al. Lamivudine monoprophylaxis for liver transplant recipients with non-replicating hepatitis B virus infection [J]. Clin Transplant, 2007; 21(2)∶166.
18. 　Samuel D, Muller R, Alexander G, et al. Liver transplantation in European patients with the hepatitis B surface antigen [J]. N Engl J Med, 1993; 329(25)∶1842.
19. 　Roche B, Feray C, Gigou M, et al. HBV DNA persistence 10 years after liver transplantation despite successful anti-HBS passive immunoprophylaxis [J]. Hepatology, 2003; 38(1)∶86.
20. 　Devlin J, Smith HM, O’Grady JG, et al. Impact of immunoprophylaxis and patient selection on outcome of transplantation for HBsAg-positive liver recipients [J]. J Hepatol, 1994; 21(2)∶204.
21. 　Terrault NA, Zhou S, Combs C, et al. Prophylaxis in liver transplant recipients using a fixed dosing schedule of hepatitis B immunoglobulin [J]. Hepatology, 1996; 24(6)∶1327.
22. 　Terrault NA, Zhou S, McCory RW, et al. Incidence and clinical consequences of surface and polymerase gene mutations in liver transplant recipients on hepatitis B immunoglobulin [J]. Hepatology, 1998; 28(2)∶555.
23. 　Shouval D, Samuel D. Hepatitis B immune globulin to prevent hepatitis B virus graft reinfection following liver transplantation: a concise review [J]. Hepatology, 2000; 32(6)∶1189.
24. 　Mentha G, Giostra E, Negro F, et al. High-titered anti-HBs fresh frozen plasma for immunoprophylaxis against hepatitis B virus recurrence after liver transplantation [J]. Transplant Proc, 1997; 29(5)∶2369.
25. 　Terrault NA, Vyas G. Hepatitis B immune globulin preparations and use in liver transplantation [J]. Clin Liver Dis, 2003; 7(3)∶537.
26. 　Angus PW, McCaughan GW, Gane EJ, et al. Combination low-dose hepatitis B immune globulin and lamivudine therapy provides effective prophylaxis against posttransplantation hepatitis B [J]. Liver Transpl, 2000; 6(4)∶429.
27. 　Neff GW, Kemmer N, Kaiser TE, et al. Combination therapy in liver transplant recipients with hepatitis B virus without hepatitis B immune globulin [J]. Dig Dis Sci, 2007; 52(10)∶2497.
28. 　Bock CT, Tillmann HL, Torresi J, et al. Selection of hepatitis B virus polymerase mutants with enhanced replication by lamivudine treatment after liver transplantation [J]. Gastroenterology, 2002; 122(2)∶264.
29. 　Dodson SF, de Vera ME, Bonham CA, et al. Lamivudine after hepatitis B immune globulin is effective in preventing hepatitis B recurrence after liver transplantation [J]. Liver Transpl, 2000; 6(4)∶434.
30. 　Naoumov NV, Lopes AR, Burra P, et al. Randomized trial of lamivudine versus hepatitis B immunoglobulin for long-term prophylaxis of hepatitis B recurrence after liver transplantation [J]. J Hepatol, 2001; 34(6)∶888.
31. 　Neff GW, O’brien CB, Nery J, et al. Outcomes in liver transplant recipients with hepatitis B virus: resistance and recurrence patterns from a large transplant center over the last decade [J]. Liver Transpl, 2004; 10(11)∶1372.
  1. 1. 　Steinmuller T, Seehofer D, Rayes N, et al. Increasing applicability of liver transplantation for patients with hepatitis B-related liver disease [J]. Hepatology, 2002; 35(6)∶1528.
  2. 2. 　Yao FY, Terrault NA, Freise C, et al. Lamivudine treatment is beneficial in patients with severely decompensated cirrhosis and actively replicating hepatitis B infection awaiting liver transplantation: a comparative study using a matched, untreated cohort [J]. Hepatology, 2001; 34(2)∶411.
  3. 3. 　Perrillo RP, Wright T, Rakela J, et al. A multicenter United States-Canadian trial to assess lamivudine monotherapy before and after liver transplantation for chronic hepatitis B [J]. Hepatology, 2001; 33(2)∶424.
  4. 4. 　Villeneuve JP, Condreay LD, Willems B, et al. Lamivudine treatment for decompensated cirrhosis resulting from chronic hepatitis B [J]. Hepatology, 2000; 31(1)∶207.
  5. 5. 　Lo CM, Cheung ST, Lai CL, et al. Liver transplantation in Asian patients with chronic hepatitis B using lamivudine prophylaxis [J]. Ann Surg, 2001; 233(2)∶276.
  6. 6. 　Perillo RP. Potential importance of the sexual transmission of non-A, non-B hepatitis [J]. Hepatology, 1991; 13(4)∶805.
  7. 7. 　Fontana RJ, Hann HW, Perrillo RP, et al. Determinants of early mortality in patients with decompensated chronic hepatitis B treated with antiviral therapy [J]. Gastroenterology, 2002; 123(3)∶719.
  8. 8. 　Peters MG, Hann Hw H, Martin P, et al. Adefovir dipivoxil alone or in combination with lamivudine in patients with lamivudine-resistant chronic hepatitis B [J]. Gastroenterology, 2004; 126(1)∶91.
  9. 9. 　Schiff ER, Lai CL, Hadziyannis S, et al. Adefovir dipivoxil therapy for lamivudine-resistant hepatitis B in pre- and post-liver transplantation patients [J]. Hepatology， 2003; 38(6)∶1419.
  10. 10. 　Villeneuve JP, Durantel D, Durantel S, et al. Selection of a hepatitis B virus strain resistant to adevir in a liver transplantation patient [J]. J Hepalo, 2003; 39(6)∶1085.
  11. 11. 　Yang H, Westland CE, Delaney WE 4th, et al. Resistance surveillance in chronic hepatitis B patients treated with adefovir dipivoxil for up to 60 weeks [J]. Hepatology， 2002; 36(2)∶464〖HJ*2〗12　Grellier L, Mutimer D, Ahmed M, et al. Lamivudine prophylaxis against reinfection in liver transplantation for hepatitis B cirrhosis [J]. Lancet， 1996; 348(9036)∶1212.
  12. 12. 　嚴(yán)茂林, 嚴(yán)律南， 李波， 等. 拉米夫定對(duì)肝移植術(shù)后乙肝病毒再感染的預(yù)防作用 [J]. 中國普外基礎(chǔ)與臨床雜志， 2006； 13（2）∶205.
  13. 13. 　Mutimer D, Pillay D, Shields P, et al. Outcome of lamivudine resistant hepatitis B virus infection in the liver transplant recipient [J]. Gut， 2000; 46(1)∶107.
  14. 14. 　Wai CT, Prabhakaran K, Wee A, et al. Adefovir dipivoxil as the rescue therapy for lamivudine-resistant hepatitis B post liver transplant [J]. Transplant Proc, 2004; 36(8)∶2313.
  15. 15. 　Palumbo E. Recent advances in the treatment of the hepatitis HBV-related. Effectiveness and tolerability of adefovir dipivoxil [J]. Recenti Prog Med, 2007; 98(4)∶237.
  16. 16. 　Barcena R, Del Campo S, Moraleda G, et al. Study on the efficacy and safety of adefovir dipivoxil treatment in post-liver transplant patients with hepatitis B virus infection and lamivudine-resistant hepatitis B virus [J]. Transplant Proc, 2005; 37(9)∶3960.
  17. 17. 　Yoshida H, Kato T, Levi DM, et al. Lamivudine monoprophylaxis for liver transplant recipients with non-replicating hepatitis B virus infection [J]. Clin Transplant, 2007; 21(2)∶166.
  18. 18. 　Samuel D, Muller R, Alexander G, et al. Liver transplantation in European patients with the hepatitis B surface antigen [J]. N Engl J Med, 1993; 329(25)∶1842.
  19. 19. 　Roche B, Feray C, Gigou M, et al. HBV DNA persistence 10 years after liver transplantation despite successful anti-HBS passive immunoprophylaxis [J]. Hepatology, 2003; 38(1)∶86.
  20. 20. 　Devlin J, Smith HM, O’Grady JG, et al. Impact of immunoprophylaxis and patient selection on outcome of transplantation for HBsAg-positive liver recipients [J]. J Hepatol, 1994; 21(2)∶204.
  21. 21. 　Terrault NA, Zhou S, Combs C, et al. Prophylaxis in liver transplant recipients using a fixed dosing schedule of hepatitis B immunoglobulin [J]. Hepatology, 1996; 24(6)∶1327.
  22. 22. 　Terrault NA, Zhou S, McCory RW, et al. Incidence and clinical consequences of surface and polymerase gene mutations in liver transplant recipients on hepatitis B immunoglobulin [J]. Hepatology, 1998; 28(2)∶555.
  23. 23. 　Shouval D, Samuel D. Hepatitis B immune globulin to prevent hepatitis B virus graft reinfection following liver transplantation: a concise review [J]. Hepatology, 2000; 32(6)∶1189.
  24. 24. 　Mentha G, Giostra E, Negro F, et al. High-titered anti-HBs fresh frozen plasma for immunoprophylaxis against hepatitis B virus recurrence after liver transplantation [J]. Transplant Proc, 1997; 29(5)∶2369.
  25. 25. 　Terrault NA, Vyas G. Hepatitis B immune globulin preparations and use in liver transplantation [J]. Clin Liver Dis, 2003; 7(3)∶537.
  26. 26. 　Angus PW, McCaughan GW, Gane EJ, et al. Combination low-dose hepatitis B immune globulin and lamivudine therapy provides effective prophylaxis against posttransplantation hepatitis B [J]. Liver Transpl, 2000; 6(4)∶429.
  27. 27. 　Neff GW, Kemmer N, Kaiser TE, et al. Combination therapy in liver transplant recipients with hepatitis B virus without hepatitis B immune globulin [J]. Dig Dis Sci, 2007; 52(10)∶2497.
  28. 28. 　Bock CT, Tillmann HL, Torresi J, et al. Selection of hepatitis B virus polymerase mutants with enhanced replication by lamivudine treatment after liver transplantation [J]. Gastroenterology, 2002; 122(2)∶264.
  29. 29. 　Dodson SF, de Vera ME, Bonham CA, et al. Lamivudine after hepatitis B immune globulin is effective in preventing hepatitis B recurrence after liver transplantation [J]. Liver Transpl, 2000; 6(4)∶434.
  30. 30. 　Naoumov NV, Lopes AR, Burra P, et al. Randomized trial of lamivudine versus hepatitis B immunoglobulin for long-term prophylaxis of hepatitis B recurrence after liver transplantation [J]. J Hepatol, 2001; 34(6)∶888.
  31. 31. 　Neff GW, O’brien CB, Nery J, et al. Outcomes in liver transplant recipients with hepatitis B virus: resistance and recurrence patterns from a large transplant center over the last decade [J]. Liver Transpl, 2004; 10(11)∶1372.