Abstract
Background: A combination of hepatitis B immunoglobulin and nucleos(t)ide analogues is the current standard of care for controlling hepatitis B recurrence after orthotopic liver transplantation (OLT). However, frequent immunoglobulin treatment is expensive and inconvenient. This study investigated the efficacy of hepatitis B virus (HBV) vaccination in preventing the recurrence of hepatitis B after living donor OLT. Methods: Twenty-seven patients who had undergone living donor OLT participated in the study; five had acute HBV infected liver failure (ALF-OLT) and 22 had HBV related liver cirrhosis (LC-OLT). Hepatitis B surface antigen (HBsAg)-containing vaccine was administered to them for at least 1 year after transplantation and continued once monthly for up to 36 months post-OLT. Patients who had anti-HBs antibody titers above 100 mIU/mL for a minimum of 6 months without immunoglobulin administration were defined as good responders; the others were defined as poor responders. Interferon-γ enzyme-linked immunospot assays against HBs and HBc antigens were used to assay cellular immune responses. Results: All five of the ALF-OLT patients had good responses after a median of four (range 2.5-5) vaccinations. Nine of the 22 LC-OLT patients had good responses after a median of 19 (range 11.5-30) vaccinations. Among the LC-OLT group, those with livers donated by relatively higher-aged, marital and high-titer anti-HBs antibody donors were good responders. LC-OLT patients classed as good responders showed interferon-γ responses comparable to those of the ALF-OLT patients. Conclusions: The ALF-OLT and LC-OLT patients who received livers from relatively higher-aged, marital, high-titer anti-HBs antibody donors were the best candidates for HBV vaccine administration. Boosting donors before transplantation may facilitate later vaccine response of the recipients.
| Original language | English |
|---|---|
| Pages (from-to) | 1373-1383 |
| Number of pages | 11 |
| Journal | Journal of Gastroenterology |
| Volume | 48 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 2013 |
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Keywords
- Hepatitis B immunoglobulin
- Immune response
- Living donor liver transplantation
- Marital donor
- Vaccination
ASJC Scopus subject areas
- Gastroenterology
Cite this
Which patients respond best to hepatitis B vaccination after a hepatitis B virus-related liver transplantation? / Takaki, Akinobu; Yagi, Takahito; Yasunaka, Tetsuya; Sadamori, Hiroshi; Shinoura, Susumu; Umeda, Yuzo; Yoshida, Ryuichi; Sato, Daisuke; Nobuoka, Daisuke; Utsumi, Masashi; Yasuda, Yuko; Nakayama, Eiichi; Miyake, Yasuhiro; Ikeda, Fusao; Shiraha, Hidenori; Nouso, Kazuhiro; Fujiwara, Toshiyoshi; Yamamoto, Kazuhide.
In: Journal of Gastroenterology, Vol. 48, No. 12, 12.2013, p. 1373-1383.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Which patients respond best to hepatitis B vaccination after a hepatitis B virus-related liver transplantation?
AU - Takaki, Akinobu
AU - Yagi, Takahito
AU - Yasunaka, Tetsuya
AU - Sadamori, Hiroshi
AU - Shinoura, Susumu
AU - Umeda, Yuzo
AU - Yoshida, Ryuichi
AU - Sato, Daisuke
AU - Nobuoka, Daisuke
AU - Utsumi, Masashi
AU - Yasuda, Yuko
AU - Nakayama, Eiichi
AU - Miyake, Yasuhiro
AU - Ikeda, Fusao
AU - Shiraha, Hidenori
AU - Nouso, Kazuhiro
AU - Fujiwara, Toshiyoshi
AU - Yamamoto, Kazuhide
PY - 2013/12
Y1 - 2013/12
N2 - Background: A combination of hepatitis B immunoglobulin and nucleos(t)ide analogues is the current standard of care for controlling hepatitis B recurrence after orthotopic liver transplantation (OLT). However, frequent immunoglobulin treatment is expensive and inconvenient. This study investigated the efficacy of hepatitis B virus (HBV) vaccination in preventing the recurrence of hepatitis B after living donor OLT. Methods: Twenty-seven patients who had undergone living donor OLT participated in the study; five had acute HBV infected liver failure (ALF-OLT) and 22 had HBV related liver cirrhosis (LC-OLT). Hepatitis B surface antigen (HBsAg)-containing vaccine was administered to them for at least 1 year after transplantation and continued once monthly for up to 36 months post-OLT. Patients who had anti-HBs antibody titers above 100 mIU/mL for a minimum of 6 months without immunoglobulin administration were defined as good responders; the others were defined as poor responders. Interferon-γ enzyme-linked immunospot assays against HBs and HBc antigens were used to assay cellular immune responses. Results: All five of the ALF-OLT patients had good responses after a median of four (range 2.5-5) vaccinations. Nine of the 22 LC-OLT patients had good responses after a median of 19 (range 11.5-30) vaccinations. Among the LC-OLT group, those with livers donated by relatively higher-aged, marital and high-titer anti-HBs antibody donors were good responders. LC-OLT patients classed as good responders showed interferon-γ responses comparable to those of the ALF-OLT patients. Conclusions: The ALF-OLT and LC-OLT patients who received livers from relatively higher-aged, marital, high-titer anti-HBs antibody donors were the best candidates for HBV vaccine administration. Boosting donors before transplantation may facilitate later vaccine response of the recipients.
AB - Background: A combination of hepatitis B immunoglobulin and nucleos(t)ide analogues is the current standard of care for controlling hepatitis B recurrence after orthotopic liver transplantation (OLT). However, frequent immunoglobulin treatment is expensive and inconvenient. This study investigated the efficacy of hepatitis B virus (HBV) vaccination in preventing the recurrence of hepatitis B after living donor OLT. Methods: Twenty-seven patients who had undergone living donor OLT participated in the study; five had acute HBV infected liver failure (ALF-OLT) and 22 had HBV related liver cirrhosis (LC-OLT). Hepatitis B surface antigen (HBsAg)-containing vaccine was administered to them for at least 1 year after transplantation and continued once monthly for up to 36 months post-OLT. Patients who had anti-HBs antibody titers above 100 mIU/mL for a minimum of 6 months without immunoglobulin administration were defined as good responders; the others were defined as poor responders. Interferon-γ enzyme-linked immunospot assays against HBs and HBc antigens were used to assay cellular immune responses. Results: All five of the ALF-OLT patients had good responses after a median of four (range 2.5-5) vaccinations. Nine of the 22 LC-OLT patients had good responses after a median of 19 (range 11.5-30) vaccinations. Among the LC-OLT group, those with livers donated by relatively higher-aged, marital and high-titer anti-HBs antibody donors were good responders. LC-OLT patients classed as good responders showed interferon-γ responses comparable to those of the ALF-OLT patients. Conclusions: The ALF-OLT and LC-OLT patients who received livers from relatively higher-aged, marital, high-titer anti-HBs antibody donors were the best candidates for HBV vaccine administration. Boosting donors before transplantation may facilitate later vaccine response of the recipients.
KW - Hepatitis B immunoglobulin
KW - Immune response
KW - Living donor liver transplantation
KW - Marital donor
KW - Vaccination
UR - http://www.scopus.com/inward/record.url?scp=84891491920&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84891491920&partnerID=8YFLogxK
U2 - 10.1007/s00535-013-0763-8
DO - 10.1007/s00535-013-0763-8
M3 - Article
VL - 48
SP - 1373
EP - 1383
JO - Journal of Gastroenterology
JF - Journal of Gastroenterology
SN - 0944-1174
IS - 12
ER -