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- W2909805660 startingPage "20" @default.
- W2909805660 abstract "Acute infection with hepatitis B virus (HBV) can result in fulminant hepatic failure, whereas chronic HBV infection can lead to end-stage liver disease, including cirrhosis and hepatocellular carcinoma. Approximately 2 billion individuals have been infected with HBV worldwide, and it has been estimated that 350 million persons harbor chronic HBV.[1]The role of liver transplantation (LT) in the treatment of individuals infected with HBV has undergone a fundamental shift over the past 2 decades. In the 1980s, HBV recurrence was highly prevalent post LT,[2] and poor patient and graft survival led some transplant centers to exclude patients with HBV-induced liver disease from transplant consideration. Large, single-center data in the early 1990s demonstrated increased mortality and graft dysfunction in hepatitis B surface antigen (HBsAg)-positive patients as compared with HBsAg-negative patients undergoing LT,[3] with liver grafts particularly susceptible to an aggressive variant of HBV-associated liver injury known as fibrosing cholestatic hepatitis.[4] Subsequently, in the United States, reimbursement for LT due to HBV-associated liver disease was suspended by Medicare.[5]However, with the advent of immunoprophylactic and pharmacologic interventions aimed at protecting the graft and minimizing viral replication in the peritransplant period, disease recurrence and survival rates have been dramatically altered to the extent that HBV-induced fulminant or end-stage hepatic failure is an accepted indication for LT.[6] HBV-induced liver disease currently accounts for 5% to 10% of all liver transplants.[7]This review discusses the evolution of treatment strategies and current recommendations for management of the HBV-infected LT candidate or recipient. Emphasis is placed on pre- and posttransplant strategies to prevent disease recurrence. It also covers de novo HBV infection post transplant, with particular focus on the implications of using livers from donors with detectable HBV seromarkers, as well as on the diagnosis and treatment of fibrosing cholestatic hepatitis." @default.
- W2909805660 created "2019-01-25" @default.
- W2909805660 creator A5020069661 @default.
- W2909805660 creator A5063634793 @default.
- W2909805660 date "2005-04-18" @default.
- W2909805660 modified "2023-09-23" @default.
- W2909805660 title "Hepatitis B Virus Infection in Liver Transplant Candidates and Recipients" @default.
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