B형간염 표면항체 양성인 환자에서 간이식 후 B형간염 재발에 대한 예방법으로서 B형간염 면역글로불린과 라미부딘의 효과 비교
Prophylaxis against Hepatitis B Recurrence Following Liver Transplantation in HBsAg(+) Patients Hepatitis B Immune Globulin vs Lamivudine -
이광웅, 박재범, 조재원, 김성주, 송건도, 최성호, 허진석, 김용일, 이병붕, 김정한, 이석구,
소속 상세정보
이광웅 ( Lee Kwang-Woong )
성균관대학교 의과대학 삼성서울병원 일반외과
박재범 ( Park Jae-Berm )
성균관대학교 의과대학 삼성서울병원 외과학교실
조재원 ( Cho Jae-Won )
성균관대학교 의과대학 삼성서울병원 일반외과
김성주 ( Kim Sung-Ju )
성균관대학교 의과대학 삼성서울병원 외과학교실
송건도 ( Song Geon-Do )
성균관대학교 의과대학 삼성서울병원 일반외과
최성호 ( Choi Seong-Ho )
성균관대학교 의과대학 삼성서울병원 외과학교실
허진석 ( Heo Jin-Seok )
성균관대학교 의과대학 삼성서울병원 외과학교실
김용일 ( Kim Yong-Il )
성균관대학교 의과대학 삼성서울병원 일반외과
이병붕 ( Lee Byung-Boong )
성균관대학교 의과대학 삼성서울병원 일반외과
김정한 ( Kim Jung-Han )
성균관대학교 의과대학 삼성서울병원 외과학교실
이석구 ( Lee Suk-Koo )
성균관대학교 의과대학 삼성서울병원 외과
KMID : 0371320010600060640
Abstract
Purpose
Thanks to hepatitis B immune globulin (HBIG) and antiviral agents such as Lamivudine , HBV cirrhosis is no longer a contraindication of liver transplantation. Actually it is frequent indication for liver transplantation in Korea.
However, to
date, the most effective HBV prophylaxis regimen has not been determined. The purpose of this study was to evaluate whether the regimen consisting of lamivudine and one-week HBIG for the hepatitis B virus (HBV) prophylaxis following liver
transplantation is as effective as a long-term therapy of high dose HBIG.
Methods
From May 1996 to December 1999, 58 patients among a total of 80 cases of liver transplantation were hepatitis B surface antigen positive preoperatively. They were grouped into two protocol regimens, the HBIG group and the Lamivudine
combination group, at random. 43 patients (19 patients in the HBIG group, twenty four patients in the Lamivudine combination group) who survived more than 90 days were included in this study. The recurrence was defined as the
conversion
of
HBs-Ag from negative to positive.
Results
There was no statistical significance between the two groups in regards to age, sex or the preoperative positive rate of HBeAg. The mean follow-up duration was 27 months (range from 6-55). Of the 43 patients, 5 patients were converted to HBs-Ag
positive
in serum; two were in the HBIG group and three in the Lamivudine combination group. There was no statistical significance in HBV recurrence rate between the two groups (p=0.97).
Conclusion
The combined therapy of lamivudine and one week HBIG has an effect equivalent to a long term therapy of high dose HBIG in HBV prophylaxis following liver transplantation.
키워드
B형간염의 재발; 예방; 간이식; B형간염 면역글로불린; 라미부딘; HBV recurrence; Prophylaxis; Liver transplantation; Hepatitis B Immune globulin; Lamivudine ;
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