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Assessment of patient safety and the efficiency of facility utilizationfollowing simplified ultra-rapid intravenous infusion of hepatitis B immunoglobulin in a high-volume liver transplantation center
Ann Hepatobiliary Pancreat Surg 2019 May;23(2):128-32
Published online May 31, 2019;  https://doi.org/10.14701/ahbps.2019.23.2.128
Copyright © 2019 Korean Association of Hepato-Biliary-Pancreatic Surgery.

I-Ji Jeong1, Shin Hwang1,2, Dong-Hwan Jung1, Gi-Won Song1, Gil-Chun Park1, Chul-Soo Ahn1, Deok-Bog Moon1, Ki-Hun Kim1, Tae-Yong Ha1, Hea-Seon Ha2, Jung-Ja Hong2, In-Ok Kim2, Sung-Gyu Lee1

1Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 2Organ Transplantation Center, Asan Medical Center, Seoul, Korea
Received March 7, 2019; Revised March 12, 2019; Accepted March 15, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Backgrounds/Aims: This study intended to evaluate patient safety and efficiency of facility utilization following simplified ultra-rapid intravenous infusion of hepatitis B immunoglobulin (HBIG) in recipients of hepatitis B virus-associated adult liver transplantation (LT), who visited our outpatient clinic.
Methods: Our simplified ultra-rapid infusion protocol was to directly infuse 50 ml volume of 10,000 IU HBIG for 20-25 minutes on an ambulatory basis. The incidence of adverse side-effects and the efficiency of facility utilization were assessed retrospectively.
Results: A total of 1,513 patients received 12,472 sessions of HBIG infusion according to simplified ultra-rapid infusion method. Of these, 1,172 patients were converted from conventional ultra-rapid infusion method, and received 8,352 sessions of HBIG infusion for 18 months (mean 7.1 times; 4.8 times per year). The remaining 341 de novo patients received 4,120 sessions of HBIG infusion for 18 months (mean 12.1 times; 8.1 times per year). None of these patients experienced any adverse side-effects following the simplified ultra-rapid infusion. The maximal capacity of HBIG infusion sessions at the injection facility of our outpatient clinic was increased from 65-70 sessions to 80 sessions, after introduction of simplified ultra-rapid infusion method. Mean trough anti-HBs titer was lower, and mean interval of HBIG infusion was longer in the combination therapy group compared with HBIG monotherapy group.
Conclusions: Our high-volume study indicates that in nearly all LT recipients, rapid infusion of highly purified HBIG within 30 minutes was well-tolerated. This suggests that it would be reasonable to perform simplified ultra-rapid infusion protocol widely for patient convenience.
Keywords : Hepatitis B immunoglobulin; Hepatitis B virus; Prophylaxis; Liver transplantation

 

November 2019, 23 (4)