HBV transplanted patients were analysed according to indication for LT: decompensated cirrhosis (HBVdec) or hepatocellular carcinoma (HBV/HCC). These groups were compared with co-infected patients HBV/HDV (HBDV), HBV/HCV (HBCV), HBV/HDV/HCV (HBDCV); n = 16,664 and with HCV patients (n = 2452) according to LT indication.
5912 patients were transplanted for HBV (78 % HBVdec, 22 % HBV/HCC), with HBV/HCC patients who increased from 15.8 % in 1988-1995 to 29.6 % in 2006-2010 (p <0.001). In HBVdec patients, 1, 3, 5, and 10 year patient and graft survival was 83 % , 78 % , 75 % , 68 % , and 80 % , 74 % , 71 % , 64 % , respectively, significantly better than HBV/HCC (84 % , 73 % , 68 % , 61 % , and 81 % , 70 % , 65 % , 58 % respectively; p = 0.001 and p = 0.026). In 2006-2010 patient and graft survival significantly improved compared to 1988-1995, both for HBVdec and HBV/HCC (each p <0.001). A better patient and graft survival was seen in HBV/HCC patients with HBV-DNA(?) compared to HBV-DNA(+) at the time of LT (p <0.001). Disease recurrence, as cause of death/graft loss, was significantly reduced in recent years compared to the past: currently <1 % for HBVdec and 3 % for HBV/HCC.
Outcomes of LT for HBV have improved in recent years, with disease recurrence being no longer a significant cause of death/graft loss. HBV-DNA at the time of LT seems to influence survival only in HBV/HCC patients.