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Benefit of Anti-hepatitis B Immunoglobulin(HBIG) Monotherapy Compared to HBIG Combined with Entecavir in Long Term Renal Function

Background To reduce the HBV reinfection after liver transplantation, anti-hepatitis B immunoglobulin (HBIG) alone or combination with antiviral nucleotide analogues are usually used regimen. However, antiviral nucleotide analogues have nephrotoxicity, which is a critical issue because renal dysfunction frequently happens after liver transplantation. Method Medical records of 171 liver recipients with HBV who underwent liver transplantation between Sep. 2005 and Dec. 2012 were retrospectively reviewed. The difference of renal function of HBIG mono-therapy group (HBIG) and HBIG combined with Entecavir group (HBIG+ETV) were analyzed. Results There was no significant difference in age, gender, body mass index, intraoperative blood loss, and MELD score between the two groups. But the patients who had preoperative ascites, mean preoperative AST level, preoperative GFR level, and the applying event of CRRT was significantly different between the groups. The decrease of eGFR between preoperative and 1 year after transplantation was 31.5±27.2 mL/min/1.73m2 (p<0.001), in HBIG group and 40.0±45.9 mL/min/1.73m2 (p<0.001) in HBIG+ETV group. Also, the eGFR decrease between preoperative and 4-year after transplantation was 24.5±29.9 mL/min/1.73m2 (p<0.001) in HBIG group and 38.9±56.8 mL/min/1.73m2 (p<0.001) in HBIG+ETV group. Conclusion There was no difference of recurrence rate of HBV. However, HBIG+ETV combination regimen showed more declination of eGFR in long-term period after liver transplantation than HBIG alone. Figure. No caption available.