What are the indications for surgical treatment of hepatitis B (HBV) (Hep B)?

Updated: Aug 01, 2018
  • Author: Nikolaos T Pyrsopoulos, MD, PhD, MBA, FACP, AGAF; Chief Editor: BS Anand, MD  more...
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Answer

Orthotopic liver transplantation (OLT) is the treatment of choice for patients with fulminant hepatic failure who do not recover and for patients with end-stage liver disease due to hepatitis B disease. The implementation of hepatitis B immunoglobulin (HBIG) during and after the OLT period, and of lamivudine (3TC) or adefovir in the pre- and post-OLT periods, dramatically reduces the recurrence rate of hepatitis B. The current standard is to use HBIG and tenofovir disoproxil fumarate (TDF) or entecavir (ETV). At some centers, HBIG is being stopped at approximately 12 months or sooner; at other centers, HBIG is no longer being used, with the focus on first-line therapy.

For more information, see the Medscape Drugs & Diseases articles Liver Transplants, Liver Transplantation, Transfusion Requirements in Liver Transplantation, and Imaging of Liver Transplantation Complications.


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