Human autologous liver transplantation is possible due to an adequate suppression of the body's immune response.
This also causes a higher hepatitis infection rate, making hepatitis prevention very important.
We describe our experience with hepatitis B virus vaccination in 140 adult liver transplant recipients, transplanted from 1986 to 1994 with more than one year of follow-up.
Excluded were those who had hepatitis B surface antigens or antibodies to those antigens before the transplant.
The vaccination schedule was 0-1-2 months with a double dose of recombinant vaccine.
The total response rate (surface antigen antibodies>10 U) was 40% (56/140) ; the rate was 47.7% in men and 26% in women.
At the end of the study, only 17.1% (24/140) of the patients had antibodies>10 U. The response rate was higher in patients with antibodies to hepatitis B core antigen (66.6%) than in those lacking antibodies (31.7%), and more long lasting (42.4% vs 11.2%). The response rate in 116 patients with booster doses was 12.9%. Six correctly vaccinated patients (4.28%) acquired new hepatitis B virus infections after the operation.
The total response rate in these patients is much lower than in the general population, and there is a rapid decline of titers, probably due to immunosuppression.
The role ofbooster doses in these patients should be clarified.
Mots-clés Pascal : Homotransplantation, Foie, Chimioprophylaxie, Hépatite virale B, Virose, Infection, Vaccination, Incidence, Etiologie, Analyse statistique, Rapport coût bénéfice, Prévention, Homme, Transplantation, Chirurgie, Economie santé, Appareil digestif pathologie, Foie pathologie
Mots-clés Pascal anglais : Homotransplantation, Liver, Chemoprophylaxis, Viral hepatitis B, Viral disease, Infection, Vaccination, Incidence, Etiology, Statistical analysis, Cost benefit ratio, Prevention, Human, Transplantation, Surgery, Health economy, Digestive diseases, Hepatic disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0191746
Code Inist : 002B25G03. Création : 21/05/1997.