加拿大肝移植后乙肝预防：一项全国性调查的结果

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-07-01 DOI:10.1016/j.transproceed.2025.05.016

Kai Zhu , Eric M. Yoshida , Daljeet Chahal , Ben Cox , Andrew W. Shih , Vladimir Marquez , Trana Hussaini

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引用次数: 0

摘要

背景：由于移植物再感染的风险，慢性乙型肝炎在肝移植（LT）中仍然是一个重要的问题。乙肝免疫球蛋白（HBIG）联合核苷(t)类似物（NAs）一直是标准的预防方法。然而，不含hbig的方案正在出现，各个移植中心的做法各不相同。本研究的目的是描述目前乙型肝炎病毒（HBV）预防政策在加拿大的LT方案。方法：通过加拿大肝移植网络对加拿大所有肝移植中心进行虚拟调查。收集HBIG使用、NA选择、监测方案和复发管理的数据，并使用描述性统计进行分析。结果：来自6个加拿大LT中心的9名受访者参与了调查。所有中心都在移植后使用HBIG，肌内注射HepaGam B是最常见的配方。HBIG的持续时间各不相同，大多数中心的治疗时间为6个月至1年。替诺福韦是主要使用的NA。大多数中心每3个月进行一次HBV复发监测。复发的处理各不相同，一些中心重新启动HBIG，而另一些中心调整NA治疗。结论：虽然HBIG和NA联合治疗仍然是加拿大的标准，但HBIG的持续时间和复发管理存在显着差异。在特定人群中，越来越多的人转向无hbigi方案，这凸显了制定标准化指南以优化移植后HBV预防的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Post-Liver Transplantation Hepatitis B Prophylaxis in Canada: Results of a National Survey

Background

Chronic hepatitis B remains a significant concern in liver transplantation (LT) due to the risk of graft reinfection. Hepatitis B immunoglobulin (HBIG), combined with nucleos(t)ide analogues (NAs), has been the standard prophylactic approach. However, HBIG-free regimens are emerging, and practices vary across transplant centers. This study aims to describe the current Hepatitis B virus (HBV) prophylaxis policies in Canadian LT programs.

Methods

A virtual survey was distributed to all LT centers in Canada through the Canadian Liver Transplant Network. Data on HBIG use, NA selection, monitoring protocols, and recurrence management were collected and analyzed using descriptive statistics.

Results

Nine respondents from 6 Canadian LT centers participated. All centers use HBIG post-transplant, with intramuscular HepaGam B being the most common formulation. HBIG duration varied, with most centers administering it for 6 months to 1 year. Tenofovir was the predominant NA used. HBV recurrence monitoring occurred every 3 months in most centers. Management of recurrence varied, with some centers reinitiating HBIG, while others adjusting NA therapy.

Conclusions

While HBIG and NA combination therapy remains the standard in Canada, significant variations exist in HBIG duration and recurrence management. A growing shift toward HBIG-free regimens in select populations highlights the need for standardized guidelines to optimize post-transplant HBV prophylaxis.

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.