1. Prevalent use of combined prophylaxis of hepatitis B after liver transplantation in Italy: results of a national survey in a large cohort
- Author
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Marzano, Alfredo, Andreone, Pietro, Boccagni, Patrizia, Burra, Patrizia, Caneschi, Francesco, Conoscitore, Pasquale F., Coppola, Carmine, De Carlis, Luciano, Fagiuoli, Stefano, Forte, Paolo, Gaeta, Giovanni B., Iemmolo, Rosa M., Suffredini, Anna Lotti, Mazzola, Michele, Merli, Manuela, Parrilli, Gianpaolo, Piai, Guido, Piras, Maria R., Salizzoni, Mauro, Tamè, Mariarosa, Tisone, Giuseppe, Toniutto, Pierluigi, Vennarecci, Giovanni, Volpes, Riccardo, Zamboni, Fausto, Caccamo, Lucio, Bertuzzo, Valentina R., Bongiovanni, Assunta S., Brin-Dicci, Gaetano, Cocchis, Donatella, Ettorre, Giuseppe M., Gianni, Elena, Giusto, Michela, Lenisa, Ilaria, Lucà, Maria G., Mameli, Laura, Mangoni, Iacopo, Manini, Matteo A., Paoli, Serena, Russo, Francesco P., Staiano, Laura, Stornaiuolo, Gianfranca, Toti, Luca, Valente, Giovanna, Vukotic, Ranka, Ispheb, Group, Marzano, Alfredo, Andreone, Pietro, Boccagni, Patrizia, Burra, Patrizia, Caneschi, Francesco, Conoscitore, Pasquale F, Coppola, Carmine, DE Carlis, Luciano, Fagiuoli, Stefano, Forte, Paolo, Gaeta, Giovanni B, Iemmolo, Rosa M, Lotti Suffredini, Anna, Mazzola, Michele, Merli, Manuela, Parrilli, Gianpaolo, Piai, Guido, Piras, Maria R, Salizzoni, Mauro, Tamè, Mariarosa, Tisone, Giuseppe, Toniutto, Pierluigi, Vennarecci, Giovanni, Volpes, Riccardo, Zamboni, Fausto, Caccamo, Lucio, Marzano, A, Andreone, P, Boccagni, P, Burra, P, Caneschi, F, Conoscitore, P, Coppola, C, De Carlis, L, Fagiuoli, S, Forte, P, Gaeta, G, Iemmolo, R, Suffredini, A, Mazzola, M, Merli, M, Parrilli, G, Piai, G, Piras, M, Salizzoni, M, Tamè, M, Tisone, G, Toniutto, P, Vennarecci, G, Volpes, R, Zamboni, F, Caccamo, L, Bertuzzo, V, Bongiovanni, A, Brin-Dicci, G, Cocchis, D, Ettorre, G, Gianni, E, Giusto, M, Lenisa, I, Lucà, M, Mameli, L, Mangoni, I, Manini, M, Paoli, S, Russo, F, Staiano, L, Stornaiuolo, G, Toti, L, Valente, G, and Vukotic, R
- Subjects
0106 biological sciences ,Prophylaxis reinfection ,Hepatitis B virus-liver transplantation ,Immunoglobulins ,Chemoprevention ,Health Care Surveys ,Hepatitis B ,Hepatitis B Core Antigens ,Humans ,Italy ,Postoperative Complications ,Practice Patterns, Physicians' ,Retrospective Studies ,Tissue Donors ,Liver Transplantation ,Internal Medicine ,Endocrinology, Diabetes and Metabolism ,Nutrition and Dietetics ,Gastroenterology ,medicine.medical_treatment ,Practice Patterns ,Liver transplantation ,01 natural sciences ,0302 clinical medicine ,Endocrinology ,Epidemiology ,Nutrition and Dietetic ,Hepatitis B virus ,virus diseases ,Entecavir ,Diabetes and Metabolism ,Hepatocellular carcinoma ,Coinfection ,030211 gastroenterology & hepatology ,medicine.drug ,medicine.medical_specialty ,Virus ,03 medical and health sciences ,010608 biotechnology ,Internal medicine ,medicine ,Immunoglobulin ,Liver Transplantation, Hepatitis B, Prophylaxis reinfection ,Physicians' ,business.industry ,Retrospective cohort study ,medicine.disease ,digestive system diseases ,Settore MED/18 ,business - Abstract
BACKGROUND Prophylaxis of hepatitis B after liver transplantation with antiviral(s) and immunoglobulins efficiently protect the majority of recipients; however recent experiences suggest a decline of HBsAg-positive candidates and the use of hepatitis B Immunoglobulin-free schedules. METHODS This national survey evaluated the epidemiology and clinical results of hepatitis B prophylaxis among 10,365 liver transplants performed in 25 years in 13 Italian centers. RESULTS With a percentage of 22, 2260 procedures were performed in HBsAg-positive recipients and 714 out of 1080 anti-HBc-positive grafts were used in HBsAg-negative recipients; a total of 2974 patients (29%) were considered at risk of hepatitis B after liver transplantation. Similar rates (18% of HBsAg-positive candidates and 15% of anti-HBc-positive grafts) were registered in the last collected year. Combined prophylaxis with Hepatitis B Immunoglobulins remained prevalent among centers and was effective in 96% of HBsAg-positive recipients and in 94% of HBsAg-negative recipients of anti-HBc-positive grafts. CONCLUSIONS Data from this survey confirm: the excellent results of combined prophylaxis; the past and persistent use of Hepatitis B Immunoglobulin-on and only rare -off prophylactic regimens, in contrast with the newest reports; the increasing use of anti-HBc-positive grafts; the past and present high prevalence of HBsAg-positive recipients, due to an increase in candidates with either hepatocellular carcinoma and Hepatitis Delta Virus coinfection in the last years.
- Published
- 2018