Prophylaxis in liver transplant recipients using a fixed dosing schedule of hepatitis B immunoglobulin

138

Abstracts

Cytogenetic analysis of both primary and metastatic hepatoblastoma revealed the following abnormal chromosomal complements respectively: 46,XX,der(2)t(2;2)(p25;q21),der(22)t( 1;22)(q22;p13)[6]: 47,XX,der(2)t(2;2)(p 25;q21), + 20,der(22)t(l;22)q22;pl3)[4];47,XX,der(2)t(2;2)(p25;q21), + 20[1], and 18, + 20,der(22)t( 1;22)(q22;pl3)[9]/5O,XX,der(2)t(2;2)(p25; 48,XX,der(2)t(2;2)(p25;q21),+ 12,+ 17,q21), +8, + 12, + 17, + 2 0[4]. Two abnormalities, the chromosome 2 derivative and trisomy 20, are recurrent in hepatoblastoma, but the derivative involving chromosomes 1 and 22 is a novel abnormality. 96363299 Prophylaxis

Terra&

in liver

transplant

recipients

using a fixed

dosing schedule

of hepatitis

B immunoglobulin

N.A.; Zhou S.; Combs C.; Hahn J.A.; Lake J.R.; Roberts J.P.; Archer N.L.; Wright T.L.

Gastroenterology

Unit,

Veterans

Admin.

Medical

Center,

4150

Clement

St., San Francisco,

CA 94 121

HEPATOLOGY 1996 2416 (1327- 1333) Prophylactic hepatitis B immunoglobulin (HBIg) reduces the risk of reinfection in hepatitis B surface antigen (HBsAg)-positive liver transplant recipients. In the medical center of this study, high-dose HBIg immunoprophylaxis is administered at a fixed dose of 10000 IU monthly, and in this study, the long-term efficacy of this treatment regimen was examined. Of 52 HBsAg-positive liver transplant recipients, 24 were administered HBIg immunoprophylaxis, and 28 were administered no specific therapy; the 2-year recurrence rates (defined by the reappearance of HBsAg) were 19 and 76%. respectively. Percent, 54, of the HBIg-treated patients were positive for HBeAg or hepatitis B virus (HBV) DNA (by hybridization assay) pretransplantation. In patients administered monthly HBIg, intrapatient and interpatient variability in trough antibody to HBsAg (anti-HBs) titer was significant, highlighting the potential difficulties of using anti-HBs titer to guide therapy. Though anti-HBs titers were less in patients who became HBsAg positive than in patients who remained HBsAg-negative (490 versus 1290 mu/ml) (P= O.OOOl), reflecting either the cause or effect of HBV reinfection. Of nine patients who remained HBsAg-negative and who were administered monthly HBIg for at least 1 year, HBV DNA by polymerase chain reaction amplification was detectable in the sera of 67%. the lymphocytes of 50%. and the liver of 57%. In conclusion, a fixed monthly dose of HBlg reduces the recurrence of HBs antigenemia, even in patients with indices of active viral replication pretransplantation. The presence of residual virus in the majority of patients administered HBIg suggests that long-term HBlg administration may be necessary. 96363957 Viral dynamics serum virions

of hepatitis

C early

after

orthotopic

liver

transplantation:

Evidence

for rapid

turnover

of

Fukumoto T.; Berg T.; Ku Y.; Bechstein W.O.; Knoop M.; Lemmens H.-P.; Lobeck H.; Hopf U.; Neuhaus P. First

Department

of’ Surgery,

Kobe

Uniwrsity

School

qf Medicine,

7-5-2

Kusunoki-cho,

Chuo-ku,

Kobe

650 HEPATOLOGY 1996 24:6 (1351-1354) The pathogenesis of hepatitis C virus (HCV) infection is likely to be associated with viral replication in vivo, but little is known concerning the dynamics of HCV turnover. We performed serial measurements of serum HCV-RNA levels following orthotopic liver transplantation (OLT) in nine patients with HCV-positive cirrhosis. Serum HCV-RNA levels were determined by quantitative polymerase chain reaction before, immediately after, and for up to 1 month after OLT. There was a rapid decline in HCV-RNA levels from 3.1 k 1.3 x 105 copies/ml (mean f S.E.M.) preoperatively to 0.15 + 0.6 x 105 copies/ml on the first and 0.16 k 0.6 x 105 copies,/ml on the second postoperative day (mean viral half-life, 4.0 + 0.5 h). Thereafter, HCV-RNA levels increased in all but one patient, and by postoperative day 8 reached 3.6 k 1.3 x 105 copies/ml, exceeding the preoperative levels irrespective of the use or not of rescue immunosuppressive therapy including steroid bolus administration. In most patients, serum virions continued to increase averaging 11.6 + 2.8 x 105 copies/ml on the 30th postoperative day. These findings indicate that the half-life of HCV is quite short, and that extrahepatic viral replication contributes little to the total virus pool in serum. Furthermore, the marked HCV replication beginning as early as the third postoperative day strongly suggests that the liver graft is rapidly reinfected by HCV after OLT, 96363962