Patient survival after tertiary liver transplantation

✍ Scribed by Kumar, Nagappan ;Wall, William J. ;Grant, David R. ;Ghent, Cameron N.

• Publisher: Wiley (John Wiley & Sons)
• Year: 1998
• Tongue: English
• Weight: 29 KB
• Volume: 4
• Category: Article
• ISSN: 1074-3022
• DOI: 10.1002/lt.500040516

✦ Synopsis

To the Editors:

De novo hepatitis B infection after liver transplantation, in spite of its low prevalence as found by Fabia et al, 1 is of major concern, especially for infected patients and their families. More follow-up time is needed to assess the real impact in morbidity, mortality, and economic costs.

Although the serological response to hepatitis B vaccination is poor, 2 it is worthwhile to vaccinate patients because vaccines can offer some protection even when antibody to hepatitis B surface antigen (HBsAg) is not detected after vaccination.

Concerning the question of how hepatitis B was transmitted to these immunosuppressed patients, in the same way that we must be aware of the role played by the antibody to hepatitis B core antigen positivity of a donor liver, we must be attentive to the hepatitis B vaccination status of all health care personnel. In fact, the hepatitis B virus in the hospital environment these days is a risk not only for health personnel, but also for patients. 3 Transmission of hepatitis B virus to patients by infected surgeons who are chronic carriers of HBsAg has been documented repeatedly and recently. 4,5 Are all surgeons and dentists who care for liver transplant patients adequately vaccinated against hepatitis B? 6 Are they all HBsAg negative also?