23. What is the prophylaxis treatment to prevent hepatitis B (HBV) recurrence after transplant?
As long as they use the right combination of
protocols to prevent recurrence. The way we do it is right at the time of
transplant, we give them a big dose of hepatitis B immune globulin (HBIG), and we
keep up the dose for about 7 days, and we also give some
lamivudine. In the population that does not have a high
viral load, just using immune globulin will cause a very low
recurrence rate. But HBIG is expensive. But if you just use
lamivudine without HBIG, the recurrence rate is much higher, so you
have to use the HBIG. You are looking for a certain level of HBIG
in the blood, and very often with patients, after one or two years,
you can drop the dose to maybe once every 6 weeks.
22. What liver cancer screening should be done in people with normal ALTs (liver enzyme levels)?
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