One‐year extended, monthly vaccination prophylaxis combined with hepatitis B immune globulin for hepatitis B after liver transplantation

Junichi Togashi; Nobuhisa Akamatsu; Yasuhiko Sugawara; Junichi Kaneko; Sumihito Tamura; Tomohiro Tanaka; Junichi Arita; Yoshihiro Sakamoto; Kiyoshi Hasegawa; Norihiro Kokudo

doi:10.1111/hepr.12526

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One‐year extended, monthly vaccination prophylaxis combined with hepatitis B immune globulin for hepatitis B after liver transplantation

Journal article

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One‐year extended, monthly vaccination prophylaxis combined with hepatitis B immune globulin for hepatitis B after liver transplantation

Junichi Togashi, Nobuhisa Akamatsu, Yasuhiko Sugawara, Junichi Kaneko, Sumihito Tamura, Tomohiro Tanaka, Junichi Arita, Yoshihiro Sakamoto, Kiyoshi Hasegawa and Norihiro Kokudo

Hepatology research, Vol.46(3), pp.E51-E59

03/2016

DOI: 10.1111/hepr.12526

PMID: 25899139

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Abstract

Aim The feasibility of vaccination in liver transplant recipients is highly controversial, and the present study aimed to investigate the efficacy of a 1‐year extended, monthly vaccine prophylaxis protocol of a second‐generation recombinant vaccine for transplant recipients. Methods The recombinant hepatitis B vaccine (10 µg) was administrated s.c. every month for 12 months as the vaccination protocol to 39 liver transplant recipients in stable condition, including those with hepatitis B‐related chronic liver disease (n = 30), those with acute hepatitis B liver failure (hepatitis B surface antibody [HBsAb], n = 4), and those with hepatitis B core antibody positive grafts (n = 5). A fixed dose of hepatitis B immune globulin (HBIG) was administrated during the study based on the monoprophylaxis approach, and the increase in the hepatitis B surface antibody titer was measured to evaluate the efficacy of the vaccination. Results The vaccination protocol was initiated a mean of 54 months (range, 13–124) after liver transplantation, and all patients tolerated the vaccination well without adverse effects. The overall hepatitis B virus (HBV) recurrence rate was 5% (2/39) based on hepatitis B surface antigen positivity, and 2% (1/39) based on HBV DNA detectability. Six (15%) patients showed a good response to vaccination with an increase in the HBsAb titer greater than 100 IU/L at the end of vaccination, but only three (8%) maintained an adequate HBsAb level to spare HBIG during the 2‐year observation period. Conclusion While a few patients demonstrated an adequate response to vaccination, the clinical indication for the HBV vaccination for liver transplant recipients is currently minimal.

vaccine

hepatitis B virus

living donor liver transplantation

liver transplantation

hepatitis B immune globulin

hepatitis B recurrence

Details

Title: Subtitle: One‐year extended, monthly vaccination prophylaxis combined with hepatitis B immune globulin for hepatitis B after liver transplantation
Creators: Junichi Togashi - Tokyo Rosai Hospital
Nobuhisa Akamatsu - University of Tokyo
Yasuhiko Sugawara - University of Tokyo
Junichi Kaneko - University of Tokyo
Sumihito Tamura - University of Tokyo
Tomohiro Tanaka - University of Tokyo
Junichi Arita - University of Tokyo
Yoshihiro Sakamoto - University of Tokyo
Kiyoshi Hasegawa - University of Tokyo
Norihiro Kokudo - University of Tokyo
Resource Type: Journal article
Publication Details: Hepatology research, Vol.46(3), pp.E51-E59
DOI: 10.1111/hepr.12526
PMID: 25899139
NLM abbreviation: Hepatol Res
ISSN: 1386-6346
eISSN: 1872-034X
Number of pages: 9
Language: English
Date published: 03/2016
Academic Unit: Gastroenterology and Hepatology; Internal Medicine
Record Identifier: 9984094523602771

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