Is vaccination against hepatitis B infection indicated in patients waiting for or after orthotopic liver transplantation

N. Calycine, G. Smallwood, J. Halcomb, M. W. Fried, Thomas D Boyer, D. H. Van Thiel

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

It is a common practice to immunize patients against hepatitis B infection while they are waiting for liver transplantation, but the efficacy of this practice is unclear. This is a retrospective analysis of the antibody response to 20 μg of a recombinant hepatitis B vaccine in patients waiting for and after liver transplantation. The response to vaccination was measured 1-3 months after completion of the vaccination series. The risk of acquiring hepatitis B virus after liver transplant was determined by reviewing the results of tests for hepatitis B infection in 171 patients who underwent transplantation for non-hepatitis B diseases and who had not been vaccinated. Fiftyseven patients awaiting transplantation were eligible for the study, and a response to vaccination was observed in only 9 (16%). Patients with cholestatic liver disease had a significantly higher response (6 of 14; 43%) compared with noncholestatic liver disease (3 of 43; 7%; P = .004). Fortyfive liver transplant recipients were immunized against hepatitis B after transplantation, and only 3 (6.7%) developed an antibody response. The frequency of posttransplant hepatitis B infection in the 171 patients who were not immunized and who lacked any evidence of hepatitis B infection pretransplantation was 4 of 171 (2.3%). The response rate to immunization with a recombinant hepatitis B vaccine in patients with chronic liver disease who are waiting for a liver transplant and after transplantation is poor. Given the poor response to vaccination and the low risk of acquiring hepatitis B virus after transplantation, centers need to reconsider the routine use of the hepatitis B virus vaccine in patients awaiting liver transplantation.

Fingerprint

Hepatitis B
Liver Transplantation
Vaccination
Infection
Transplantation
Hepatitis B Vaccines
Hepatitis B virus
Liver Diseases
Synthetic Vaccines
Antibody Formation
Liver
Transplants
Immunization
Chronic Disease

ASJC Scopus subject areas

  • Hepatology
  • Surgery

Cite this

@article{f5f58b9bc74f42bfba23a47363d39c53,
title = "Is vaccination against hepatitis B infection indicated in patients waiting for or after orthotopic liver transplantation",
abstract = "It is a common practice to immunize patients against hepatitis B infection while they are waiting for liver transplantation, but the efficacy of this practice is unclear. This is a retrospective analysis of the antibody response to 20 μg of a recombinant hepatitis B vaccine in patients waiting for and after liver transplantation. The response to vaccination was measured 1-3 months after completion of the vaccination series. The risk of acquiring hepatitis B virus after liver transplant was determined by reviewing the results of tests for hepatitis B infection in 171 patients who underwent transplantation for non-hepatitis B diseases and who had not been vaccinated. Fiftyseven patients awaiting transplantation were eligible for the study, and a response to vaccination was observed in only 9 (16{\%}). Patients with cholestatic liver disease had a significantly higher response (6 of 14; 43{\%}) compared with noncholestatic liver disease (3 of 43; 7{\%}; P = .004). Fortyfive liver transplant recipients were immunized against hepatitis B after transplantation, and only 3 (6.7{\%}) developed an antibody response. The frequency of posttransplant hepatitis B infection in the 171 patients who were not immunized and who lacked any evidence of hepatitis B infection pretransplantation was 4 of 171 (2.3{\%}). The response rate to immunization with a recombinant hepatitis B vaccine in patients with chronic liver disease who are waiting for a liver transplant and after transplantation is poor. Given the poor response to vaccination and the low risk of acquiring hepatitis B virus after transplantation, centers need to reconsider the routine use of the hepatitis B virus vaccine in patients awaiting liver transplantation.",
author = "N. Calycine and G. Smallwood and J. Halcomb and Fried, {M. W.} and Boyer, {Thomas D} and {Van Thiel}, {D. H.}",
year = "1998",
language = "English (US)",
volume = "4",
journal = "Liver Transplantation",
issn = "1527-6465",
publisher = "John Wiley and Sons Ltd",
number = "2",

}

TY - JOUR

T1 - Is vaccination against hepatitis B infection indicated in patients waiting for or after orthotopic liver transplantation

AU - Calycine, N.

AU - Smallwood, G.

AU - Halcomb, J.

AU - Fried, M. W.

AU - Boyer, Thomas D

AU - Van Thiel, D. H.

PY - 1998

Y1 - 1998

N2 - It is a common practice to immunize patients against hepatitis B infection while they are waiting for liver transplantation, but the efficacy of this practice is unclear. This is a retrospective analysis of the antibody response to 20 μg of a recombinant hepatitis B vaccine in patients waiting for and after liver transplantation. The response to vaccination was measured 1-3 months after completion of the vaccination series. The risk of acquiring hepatitis B virus after liver transplant was determined by reviewing the results of tests for hepatitis B infection in 171 patients who underwent transplantation for non-hepatitis B diseases and who had not been vaccinated. Fiftyseven patients awaiting transplantation were eligible for the study, and a response to vaccination was observed in only 9 (16%). Patients with cholestatic liver disease had a significantly higher response (6 of 14; 43%) compared with noncholestatic liver disease (3 of 43; 7%; P = .004). Fortyfive liver transplant recipients were immunized against hepatitis B after transplantation, and only 3 (6.7%) developed an antibody response. The frequency of posttransplant hepatitis B infection in the 171 patients who were not immunized and who lacked any evidence of hepatitis B infection pretransplantation was 4 of 171 (2.3%). The response rate to immunization with a recombinant hepatitis B vaccine in patients with chronic liver disease who are waiting for a liver transplant and after transplantation is poor. Given the poor response to vaccination and the low risk of acquiring hepatitis B virus after transplantation, centers need to reconsider the routine use of the hepatitis B virus vaccine in patients awaiting liver transplantation.

AB - It is a common practice to immunize patients against hepatitis B infection while they are waiting for liver transplantation, but the efficacy of this practice is unclear. This is a retrospective analysis of the antibody response to 20 μg of a recombinant hepatitis B vaccine in patients waiting for and after liver transplantation. The response to vaccination was measured 1-3 months after completion of the vaccination series. The risk of acquiring hepatitis B virus after liver transplant was determined by reviewing the results of tests for hepatitis B infection in 171 patients who underwent transplantation for non-hepatitis B diseases and who had not been vaccinated. Fiftyseven patients awaiting transplantation were eligible for the study, and a response to vaccination was observed in only 9 (16%). Patients with cholestatic liver disease had a significantly higher response (6 of 14; 43%) compared with noncholestatic liver disease (3 of 43; 7%; P = .004). Fortyfive liver transplant recipients were immunized against hepatitis B after transplantation, and only 3 (6.7%) developed an antibody response. The frequency of posttransplant hepatitis B infection in the 171 patients who were not immunized and who lacked any evidence of hepatitis B infection pretransplantation was 4 of 171 (2.3%). The response rate to immunization with a recombinant hepatitis B vaccine in patients with chronic liver disease who are waiting for a liver transplant and after transplantation is poor. Given the poor response to vaccination and the low risk of acquiring hepatitis B virus after transplantation, centers need to reconsider the routine use of the hepatitis B virus vaccine in patients awaiting liver transplantation.

UR - http://www.scopus.com/inward/record.url?scp=0031906879&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031906879&partnerID=8YFLogxK

M3 - Article

C2 - 9516564

AN - SCOPUS:0031906879

VL - 4

JO - Liver Transplantation

JF - Liver Transplantation

SN - 1527-6465

IS - 2

ER -