reactivation of hepatitis and lamivudine therapy in 11 hbsagpositive renal allograft recipients a single centre experience background in hepatitis b virus hbv surface antigen hbsag renal allograft recipients the mortality associated with liver disease reaches 3778 an antiviral agent lamivudine has recently been reported to be safe and effective for preventing hepatic damage in these patients although either resurgence of hbvdna levels after discontinuation or emerging resistant hbv mutants caused by longterm administration are still unsettledmethods between july 1976 and december 2003 555 renal transplantations were performed in our centre of these 11 patients who were hbsag at the time of transplantation 20 were selected for this study we investigated the incidence of hepatitis reactivation for three yr after transplantation and their clinical courses including the efficacy of lamivudine therapy in seven of the 11 patientsresults six episodes of hepatitis reactivation developed in five of the 11 patients 455 within three yr after transplantation five episodes of six occurred within four months after transplantation the patient who underwent the most severe reactivation needed intensive care including lamivudine administration and plasma exchange lamivudine caused no severe adverse effects and hbvdna levels dropped to under measurable levels within four months after lamivudine administration in all patients resistant hbv mutant emerged in only one patient who had the longest lamivudine administration of 49 monthsconclusions for hbsag renal allograft recipients careful monitoring of hbvdna levels and timely administration of lamivudine could prevent hepatic damage caused by reactivation of hepatitis