During a liver transplant, your damaged liver is removed and replaced with a healthy one from an organ donor.

The role of liver transplantation in the treatment of long-term (chronic) hepatitis B virus (HBV) infection is controversial, because transplanted organs can become reinfected with HBV.

• Recurrent infections are often severe, leading to rapid failure of the transplanted liver.
• Short-term pre- and post-transplantation interferon therapy does little to prevent reinfection. In fact, interferon can sometimes trigger rejection of the transplanted organ.¹ But the newer nucleoside reverse transcriptase inhibitors (NRTIs), such as entecavir and telbivudine, may help prevent reinfection of a transplanted liver.
• High doses of hepatitis B immune globulin (HBIG) are given to try to prevent reinfection.

Treatment with antiviral drugs may prevent reinfection or slow the failure of the transplanted liver when the drug is given before and after transplantation.

Liver transplants generally are done at large medical centers. Transplantation is very expensive.