Liver transplant patients in Hong Kong are being denied an expensive anti-hepatitis-B drug that could drastically reduce the recurrence of the disease and improve their chances of survival, according to a world- renowned surgeon. Ronald Busuttil, professor and executive chairman of the department of surgery at the University of California in Los Angeles, said transplant patients in the United States were treated post-operatively for life with lamivudine and hepatitis B immunoglobulin, reducing the recurrence of hepatitis B to almost zero. 'I could understand that, due to cost considerations, with 70 per cent of hepatitis B in Hong Kong's liver transplant patients you [would] use only lamivudine,' he said. Lamivudine has been the gold standard for treating chronic hepatitis B. The liver transplant surgeon - whose department has conducted 4,383 transplants since its first successful one in 1984 - was speaking yesterday at a special lecture at Queen Mary Hospital. In an interview with the Sunday Morning Post, Professor Busuttil said Hong Kong's liver transplant programme was 'world-class, it is one of the best around'. He said the future looked bright for transplant patients because of progress in techniques, the advent of drugs that cut down on the body's organ rejection, and control of infections that normally kill transplant patients. Lo Chung-mau, chair professor of hepatobiliary (relating to the liver and some other organs) surgery at the University of Hong Kong, said the cost of using the two drugs to prevent the recurrence of hepatitis B 'would bankrupt the system'. Hepatitis B immunoglobulin would cost HK$100,000 for the first week after transplant. 'And then afterwards you reduce the dosage, but that will still be about HK$200,000 to HK$300,000 per year per patient,' he said. About 45 per cent of liver transplants in the US were for patients with hepatitis C, which posed difficulties for transplant surgery, Professor Busuttil said. 'Their survival is not as good as hepatitis B [patients] because you can prevent hepatitis B recurrence with the drugs. We have no effective medication to prevent hepatitis C,' he said. To prevent liver failure, his advice for people was, 'don't get hepatitis B, don't get hepatitis C, don't get cirrhosis'.