中文摘要：

大多数经常使用了的背景为肝炎 B 的移植以后的复发的治疗病毒(HBV ) 感染是 lamivudine，但是这药由于 YMDD 与高抵抗率被联系变异。在初步的报告， adefovir dipivoxil (副词) 被显示了对 HBV 的 lamivudine 抵抗的紧张举办活动。然而，在在肝移植(副) 以后的 HBV 感染的治疗的临床的经验仍然不是完全清楚的。这研究被瞄准从2004年3月与在 LT.Methods 前变异的 YMDD 在病人评估副词正肝炎 B 免疫球蛋白( HBIG )的预防功效到2006年3月，有长期的肝炎 B 的 16 个病人把lamivudine抵抗的 YMDD 异种在肝移植以前检测了并且对接枝再感染作为预防在副以后与副词正另外的肌内的 HBIG 接受了治疗。为肝功能，浆液 HBsAg， anti-HBs (HBIG ) ， HBeAg， anti-HBc， anti-HBe， HBV-DNA，和 creatinine 的测试是估计的肝前或肝以后的 transplantation.Results 肝以后的移植是的这些病人的中部的后续 19.4 个月。十五个病人幸存，一个病人死于 hepatocellular 癌(HCC ) 的复发。有重要差别(10.98% 对 2.26% ， P0.05 ) 处于在有在有 HBV-DNA 的 106 copies/ml 和那些上的 HBV-DNA 的病人之间的 YMDD 变异的率不到 106 copies/ml。十五个病人(93.8%)在 4 个星期有无法发现的 HBV-DNA 并且 1 (6.3%)在在副以后的 6 个月，没有肝炎 B 复发被 HBsAg 的坚持的测试检测， HBeAg ，并且 HBV-DNA 和与副词联系的浆液 creatinine 水平的没有增加在任何与肌内的 HBIG 相结合的 patients.Conclusion 副词被观察能有效地在副以后与从 HBV 复发变异的移植前 YMDD 阻止病人。

英文摘要：

Background The most frequently used therapy for post-transplantation recurrence of hepatitis B virus （HBV） infection is lamivudine, but this drug is associated with a high resistance rate due to YMDD mutant. In preliminary reports, adefovir dipivoxil （ADV） has been shown to have activity against lamivudine-resistant strains of HBV. However, clinical experience in treatment of HBV infection after liver transplantation （LT） is still not entirely clear. This study was aimed to evaluate the prophylactic efficacy of ADV plus hepatitis B immunoglobulin （HBIG） in patients with YMDD mutant before LT. Methods From March 2004 to March 2006, 16 patients with chronic hepatitis B had lamivudine-resistant YMDD mutants detected prior to liver transplantation and received treatment with ADV plus additional intramuscular HBIG after LT as prophylaxis against graft reinfection. Tests for liver function, serum HBsAg, anti-HBs （HBIG）, HBeAg, anti-HBc, anti-HBe, HBV-DNA, and creatinine were assessed pre- or post-liver transplantation. Results The median follow-up of these patients post-liver transplantation was 19.4 months. Fifteen patients survived and one patient died of recurrence of hepatocellular carcinoma （HCC）. There was significant difference （10.98% vs. 2.26%, P〈0.05） in YMDD mutant rate between the patients with HBV-DNA over 106 copies/ml and those with HBV-DNA less than 106 copies/mi. Fifteen patients （93.8%） had undetectable HBV-DNA at 4 weeks and 1 （6.3%） at 6 months after LT. No hepatitis B recurrence was detected by persistent testing of HBsAg, HBeAg, and HBV-DNA and no increase of serum creatinine level associated with ADV was observed in any of the patients. Conclusion ADV combined with intramuscular HBIG can effectively prevent patients with pre-transplantation YMDD mutant from HBV recurrence after LT.