Clinical and Molecular Hepatology

"Ji Eun Lee"

Original Articles

Liver Transplantation

Cost-effectiveness and long-term outcomes of liver transplantation using hepatitis B core antibody-positive grafts with hepatitis B immunoglobulin prophylaxis in Korea: Kyeong Deok Kim, Ji Eun Lee, Jong Man Kim, Okjoo Lee, Na Young Hwang, Jinsoo Rhu, Gyu-Seong Choi, Kyunga Kim, Jae-Won Joh; Clin Mol Hepatol 2021;27(4):603-615.
Published online September 8, 2021; DOI: https://doi.org/10.3350/cmh.2021.0137

Background/Aims
Hepatitis B core antibody (anti-HBc)-positive donors are used as an extended donor pool, and current guidelines recommend the usage of nucleos(t)ide analogues (NAs) as prophylaxis for preventing de novo hepatitis B virus infection (DNH). We analyzed the long-term outcomes of a large cohort of liver transplantation (LT) patients receiving anti-HBc-positive grafts and evaluated the risk of DNH when hepatitis B immunoglobulin (HBIG) monotherapy was used as prophylaxis. We also compared the cost-effectiveness of HBIG and NAs.
Methods
We retrospectively reviewed 457 patients with anti-HBc-positive grafts and 898 patients with anti-HBc-negative grafts who underwent LT between January 2001 and December 2018. We compared recipient characteristics according to the anti-HBc status of the donor, and compared the costs of using NAs for the rest of the patient’s life and using HBIG to maintain hepatitis B surface antibody titers above 200 IU/L.
Results
The 1-, 5-, and 10-year patient survival rates were 87.7%, 73.5%, and 67.7%, respectively, in patients with anti-HBc-positive grafts, and 88.5%, 77.4%, and 70.3%, respectively, in patients with anti-HBc-negative grafts (P=0.113). Among 457 recipients with anti-HBc-positive grafts, 117 (25.6%) were non-HBV recipients. The overall incidence of DNH was 0.9%. When using HBIG under insurance coverage, the cumulative cost was lower compared with using NA continuously without insurance coverage in Korea.
Conclusions
Anti-HBc-positive grafts alone do not affect patient survival or graft survival. HBIG monoprophylaxis has good outcomes for preventing DNH, and the patient’s long-term cost burden is low in Korea because of the national insurance system in this cohort.

Citations

Citations to this article as recorded by

KASL clinical practice guidelines for management of chronic hepatitis B Endorsed by the East Asia Liver Alliance (EALA)
Won-Mook Choi, Ji Won Han, Tae Hyung Kim, Miyoung Choi, Moon Haeng Hur, Hyo Young Lee, Han Ah Lee, Byeong Geun Song, Heechul Nam, Jeong-Ju Yoo, Chang Hun Lee, Gi-Ae Kim, Hye Won Lee, Gwang Hyeon Choi, Young Eun Chon, Yun Bin Lee, Dong Hyun Sinn, Bo Hyun K
Clinical and Molecular Hepatology.2026; 32(3): 1029. CrossRef
Costs and health outcomes of liver transplantation for hepatocellular carcinoma: a scoping review
Uriel Palacios-Barahona, Luis Guillermo Toro Rendón, Yuli Agudelo Berruecos, Angelica Fonseca, Diego Rojas-Gualdrón
Cost Effectiveness and Resource Allocation.2026;[Epub] CrossRef
Management of Hepatitis B virus infection in patients on treatment with immunosuppressants or immunomodulators: Position Paper of Associazione Italiana Studio del Fegato (AISF), Associazione Italiana di Oncologia Medica (AIOM), Gruppo Italiano per il Trap
Mauro Viganò, Roberta D’Ambrosio, Ciro Celsa, Agostino Colli, Nicola Coppola, Bruno Daniele, Elisabetta Degasperi, Gianpiero D’Offizi, Vito Di Marco, Stefano Fagiuoli, Martina Gambato, Corrado Girmenia, Paolo Grossi, Pietro Lampertico, Andrea Lauterio, Ma
Digestive and Liver Disease.2025; 57(12): 2257. CrossRef
Clinical Significance and Remaining Issues of Anti-HBc Antibody and HBV Core-Related Antigen
Yoshihiko Yano, Itsuko Sato, Takamitsu Imanishi, Ryutaro Yoshida, Takanori Matsuura, Yoshihide Ueda, Yuzo Kodama
Diagnostics.2024; 14(7): 728. CrossRef
Survival after liver transplantation from hepatitis B-core positive donors at a quaternary care hospital in Brazil
Fabiana Siroma, Edson Abdala, Stefanie Lima do Nascimento Castro, Wellington Andraus, Luiz Augusto Carneiro D´Álbuquerque, Alice Tung Wan Song
The Brazilian Journal of Infectious Diseases.2024; 28(6): 104384. CrossRef
Long-term outcomes of active vaccination against de novo hepatitis B among pediatric recipients of living donor liver transplantations with anti-HBc (+) grafts: a retrospective case–control study
Chee-Chien Yong, Yu-Hung Lin, Wendell Z. Espinosa, I-Hsuan Chen, Shih-Ho Wang, Yi-Chia Chan, Chao-Long Chen, Chih-Che Lin
International Journal of Surgery.2024; 110(10): 6702. CrossRef
Cost-effectiveness of Kidney Transplantation From Donors at Increased Risk of Blood-borne Virus Infection Transmission
Karan K. Shah, Melanie Wyld, James A. Hedley, Karen M.J. Waller, Nicole De La Mata, Angela C. Webster, Rachael L. Morton
Transplantation.2023; 107(9): 2028. CrossRef

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Cyclooxygenase-2 and vascular endothelial growth factor in chronic hepatitis, cirrhosis and hepatocellular carcinoma: Soon Ha Kwon, Soung Won Jeong, Jae Young Jang, Ji Eun Lee, Sae Hwan Lee, Sang Gyune Kim, Young Seok Kim, Young Deok Cho, Hong Soo Kim, Boo Sung Kim, So-Young Jin; Korean J Hepatol 2012;18(3):287-294.
Published online September 25, 2012; DOI: https://doi.org/10.3350/cmh.2012.18.3.287

Abstract
PDF

Background/Aims

Cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) are up-regulated in hepatocellular carcinoma (HCC). To investigate the levels of COX-2 and VEGF expression in chronic hepatitis (CH), cirrhosis, and HCC.

Methods

The immunohistochemical expressions of COX-2 and VEGF were evaluated in tissues from patients with CH (n=95), cirrhosis (n=38), low-grade HCC (LG-HCC; n=6), and high-grade HCC (HG-HCC; n=29).

Results

The COX-2 expression scores in CH, cirrhosis, LG-HCC, and HG-HCC were 3.3±1.9 (mean±SD), 4.2±1.7, 5.5±1.0, and 3.4±2.4, respectively (CH vs. cirrhosis, P=0.016; CH vs. LG-HCC, P=0.008; LG-HCC vs. HG-HCC, P=0.004), and the corresponding VEGF expression scores were 0.9±0.8, 1.5±0.7, 1.8±0.9, and 1.6±1.1 (CH vs. cirrhosis, P<0.001; CH vs. LG-HCC, P=0.011; LG-HCC vs. HG-HCC, P=0.075). Both factors were correlated with the fibrosis stage in CH and cirrhosis (COX-2: r=0.427, P<0.001; VEGF: r=0.491, P<0.001). There was a significant correlation between COX-2 and VEGF in all of the tissue samples (r=0.648, P<0.001), and between high COX-2 and VEGF expression scores and survival (COX-2: P=0.001; VEGF: P<0.001).

Conclusions

The expressions of both COX-2 and VEGF are significantly higher in cirrhosis and LG-HCC than in CH. High COX-2 and high VEGF expressions are associated with a high survival rate.

Citations

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