Patient with hepatitis B and alcoholic liver disease before and after liver transplantation

Stephen C. Ward, Charissa Y. Chang, Lan Peng, Lawrence U. Liu

Research output: Contribution to journalReview article

Abstract

We present the case of a patient with hepatitis B virus infection and alcohol use (30 g/day by self-report) who developed cirrhosis and proceeded to liver transplantation at age 49. The explanted liver showed cirrhosis with evidence of burnt-out steatohepatitis and hepatitis B virus and a 0.7-cm focus of well-differentiated hepatocellular carcinoma. He was managed following transplant with tacrolimus, prednisone, lamivudine, adefovir, and hepatitis B immune globulin infusions. His post-transplant course was complicated by several episodes of elevated liver enzymes. Liver biopsy 3 months after liver transplantation showed acute rejection and mild steatohepatitis. Liver biopsy 6 months after liver transplantation showed marked steatosis (∼95%) with moderate steatohepatitis and evidence of treated rejection. Subsequent biopsies (15 and 21 months post liver transplantation) showed resolution of the steatohepatitis, but development of chronic rejection. We discuss the interaction of alcoholic liver disease and hepatitis B virus in the development of cirrhosis and hepatocellular carcinoma, as well as the role of liver transplantation in these patients.

Original languageEnglish (US)
Pages (from-to)233-238
Number of pages6
JournalSeminars in Liver Disease
Volume29
Issue number2
DOIs
StatePublished - May 1 2009

Keywords

  • Alcoholic liver disease
  • Cirrhosis
  • Hepatitis B virus
  • Liver transplantation

ASJC Scopus subject areas

  • Hepatology

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