| Objective:Hepatitis B recurrence is one of the most important complications after liver transplantation in patients with hepatitis B related liver disease.The aim of this study was to analyze the effect of different dosing regimens of HBIG on the recurrence rate of hepatitis B during the perioperative period of liver transplantation.Methods:A retrospective analysis of 115 cases of patients who had been followed up for more than one year in the Department of Hepatobiliary Surgery at the First People's Hospital of Kunming.From January 1,2007 to January 01,2017,these patients were the first time to perform "in situ allogeneic modified piggyback liver transplantation" in this hospital because of "hepatitis B-related liver disease."Patients were divided into A and B groups according to different HBIG use programs during perioperative period of liver transplantation.The two groups of HBIG drug regimens are as follows:Group A(the use of HBIG refers to the prevention program of the liver transplantation center of the First Central Hospital of Tianjin,and has improved;this study is referred to as the "traditional program"):Intravenous injection of 4000 U during the surgical procedure,intravenous injection of 2000 U daily for 3-7 days after surgery;subsequent adjustment based on antibody titer to 400 U intermittent intramuscular injection;6 months to 1 year following surgery to maintain titers of HBIG 200 U/L Above,the surgery was maintained at 100 U/L or more after 1 year.Group B is the new exploration drug plan group of our center:During the operation,HBIG 10000 IU was intravenously injected in the hepatic phase,and HBIG 10000 IU was intravenously administered after the perioperative blood transfusion.Both groups A and B received entecavir tablets(0.5 mg QD)for antiviral therapy before and after surgery.The different HBIG regimens for perioperative perioperative liver transplantation,and the recurrence rates of hepatitis B at 1,3,and 5 years after liver transplantation in each group and the number of HBIGs used in each regimen were analyzed.SPSS 17.0 software was used for statistical analysis.Chi-square test was used for count data,and t-test was used for measurement data.The effect of the two prevention programs on the recurrence rate of hepatitis B was evaluated.Results:A total of 115 liver transplant patients were included in this study.Three patients relapsed in the first year after surgery.Three patients in group A(3/51 patients,5.80%)and 0 patients in group B(0/64 patients,0%);After the first 3 years,6 cases relapsed,including 5 cases in group A(5/51 cases,9.80%),and 1 case in group B(1/64 cases,1.5%);6 cases relapsed in the 5th year after surgery,including A There were 5 cases(5/51 cases,9.8%),and 1 case in Group B(1/64 cases,1.5%).The recurrence rate of hepatitis B after prevention of liver transplantation was 1.8%,9.8%,and 9.8%in the 1-year,3-year,and 5-year periods,respectively.The recurrence rate of hepatitis B after the use of the B-prophylaxis in the 1-year,3-year,and 5-year periods are:0%,1.5%,1.5%.The recurrence rates of hepatitis B in both A and B prevention programs were statistically analyzed and all had statistical differences.The HBIG used in group A was 21705.88 ± 4734.11U;the HBIG used in group B was 20000 ±0000.00 U;the amount of HBIG used in group A was greater than that in group B.Statistical analysis of HBIG used in both regimens was statistically significant.Conclusions:To prevent the hepatitis B recurrence after liver transplantation in patients with hepatitis B related liver disease,the prevention effect of B scheme is better than that of A scheme.The preventive effect of the two schemes is statistically different,and B scheme is more economical and injection times are more obvious than A scheme.Reduced,patient compliance is better.Therefore,the new method of administration of HBIG during the perioperative period of liver transplantation explored by this study is more obvious than the traditional method. |
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