Long-term outcomes in liver transplant patients with hepatic C infection receiving tacrolimus or cyclosporine.
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| Abstract |
Choice of calcineurin inhibitor may be a contributing factor to deteriorating patient and graft survival following liver transplantation for hepatitis C virus (HCV). In our multicenter, open-label LIS2T study, de novo liver transplant patients stratified by HCV status were randomized to cyclosporine or tacrolimus. Follow-up data were obtained in an observational study of 95 patients. Mean follow-up was 34 and 37 months, respectively, for cyclosporine-treated (n = 47) and tacrolimus-treated (n = 48) patients. In patients not receiving antiviral therapy, 22 of 31 given cyclosporine (72%) and 24 of 29 given tacrolimus (83%) had biochemical recurrence of HCV. In 68 patients with at least one biopsy, histological evidence of HCV-related hepatitis was present in 27 of 31 (87%) cyclosporine-treated patients and 37 of 37 (100%) tacrolimus-treated patients (P = .02, chi-square test). Three-year actuarial risk of fibrosis stage 2 was 66% with cyclosporine and 90% with tacrolimus; for fibrosis stage 3 or 4 it was 46% and 80%, respectively. Three graft losses were attributed to HCV recurrence in cyclosporine-treated patients and six in tacrolimus-treated patients. Tacrolimus may be associated with increased risk of histological HCV disease recurrence compared to cyclosporine.
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| Authors | F Villamil, G Levy, G L Grazi, S Mies, D Samuel, F Sanjuan, M Rossi, J Lake, S Munn, F Mühlbacher, L Leonardi, U Cillo |
| Journal | Transplantation proceedings (Transplant Proc) Vol. 38 Issue 9 Pg. 2964-7 (Nov 2006) ISSN: 0041-1345 [Print] United States |
| PMID | 17112875 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial) |
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