Predictive Factors for Successful Vaccination Against Hepatitis B Surface Antigen in Patients Who Have Undergone Orthotopic Liver Transplantation

Ailee Ikeda, Akinobu Takaki, Tetsuya Yasunaka, Atsushi Oyama, Takuya Adachi, Nozomu Wada, Hideki Ohnishi, Fusao Ikeda, Hidenori Shiraha, Kazuhiro Yoshida, Takashi Kuise, Daisuke Nobuoka, Ryuichi Yoshida, Yuzo Umeda, Takahito Yagi, Toshiyoshi Fujiwara, Hiroyuki Okada

Research output: Contribution to journalArticle

Abstract

Post-orthotopic liver transplantation (OLT) hepatitis B recurrence is well-controlled with a nucleos(t)ide analogue and hepatitis B immunoglobulin (HBIG) combination, but the high cost and the potential risk of unknown infection associated with HBIG remain unresolved issues. Low-cost recombinant hepatitis B virus (HBV) vaccine administration is a potential solution to these problems. We retrospectively analyzed the rate and predictive factors of HBV vaccine success in 49 post-OLT patients: liver cirrhosis-type B (LC-B), n=28 patients; acute liver failure-type B (ALF-B), n=8; and non-HBV-related end-stage liver disease (non-B ESLD) who received a liver from anti-hepatitis B core antibody-positive donors, n=13. A positive anti-hepatitis B surface antibody response was achieved in 29% (8/28) of the LC-B group, 88% (7/8) of the ALF-B group, and 44% (4/9) of the adult non-B ESLD group. All four non-B ESLD infants showed vaccine success. The predictive factors for a good response in LC-B were young age, marital donor, and high donor age. ALF-B and non-B ESLD infants are thus good vaccination candidates. LC-B patients with marital donors are also good candidates, perhaps because the donated liver maintains an efficient immune memory to HBV, as the donors had already been infected in adulthood and showed adequate anti-HBV immune responses.

Original languageEnglish
Pages (from-to)41-50
Number of pages10
JournalActa medica Okayama
Volume73
Issue number1
DOIs
Publication statusPublished - Feb 1 2019

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Keywords

  • acute liver failure
  • hepatitis B
  • hepatitis B vaccine
  • liver cirrhosis
  • liver transplantation

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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