Conference proceeding
A cyclosporine-based immunosuppressive regimen may be better than tacrolimus for long-term liver allograft survival in recipients transplanted for hepatitis C
Transplantation proceedings, Vol.38(10), pp.3625-3628
World transplant congress 2006, Hynes convention center, Boston, Massachusetts, July 22-27, 2006
2006
DOI: 10.1016/j.transproceed.2006.10.040
PMID: 17175350
Abstract
Rapid recurrence of severe hepatitis C (HCV) after liver transplantation is a major barrier to survival of the transplanted liver. While cyclosporine (CsA) in vitro has been shown to suppress HCV replication, an effect is not seen with tacrolimus (Tac). Evidence is inconsistent whether or how this translates to clinical practice. To expand the evidence on this issue, we analyzed graft survival and histological outcomes after liver transplantation for HCV hepatitis.
Methods
Using our longitudinal database (1991 onward) graft outcomes for all liver transplant recipients with HCV were evaluated (105 grafts in 97 patients). Severe activity, severe fibrosis, and graft survival were analyzed. All liver biopsies were scored (blinded) according to the Ludwig scale. Immunosuppression was based on prednisone and a calcineurin inhibitor (Tac n = 89, 85%; CsA n = 15, 14%). Comparisons of outcomes using CsA versus Tac therapy were done using survival analysis via the log-rank test.
Results
Graft survival was significantly better in the CsA group. Although there was no apparent difference in severe activity (grade 2), there was a statistically significant difference in graft survival without fibrosing cholestatic hepatitis (P = .01) and a trend toward a difference in fibrosis-free survival (P = 0.1). The rate of sustained response to antiviral therapy was twice as high in the CsA group, 50% versus 22% (P = 0.16; NS).
Conclusions
Graft survival in liver transplant recipients with HCV may be greater with CsA-based immunosuppression. There may also be a lower rate of fibrosing cholestatic hepatitis in this group.
Details
- Title: Subtitle
- A cyclosporine-based immunosuppressive regimen may be better than tacrolimus for long-term liver allograft survival in recipients transplanted for hepatitis C
- Creators
- S. C RAYHILL - Oregon Health Science University, University of Iowa, United StatesR BARBEITO - Oregon Health Science University, University of Iowa, United StatesD KATZ - Oregon Health Science University, University of Iowa, United StatesM VOIGT - Oregon Health Science University, University of Iowa, United StatesD LABRECQUE - Oregon Health Science University, University of Iowa, United StatesP KIRBY - Oregon Health Science University, University of Iowa, United StatesR MILLER - Oregon Health Science University, University of Iowa, United StatesA STOLPEN - Oregon Health Science University, University of Iowa, United StatesY WU - Oregon Health Science University, University of Iowa, United StatesW SCHMIDT - Oregon Health Science University, University of Iowa, United States
- Resource Type
- Conference proceeding
- Publication Details
- Transplantation proceedings, Vol.38(10), pp.3625-3628
- Conference
- World transplant congress 2006, Hynes convention center, Boston, Massachusetts, July 22-27, 2006
- Publisher
- Elsevier Science; New York, NY
- DOI
- 10.1016/j.transproceed.2006.10.040
- PMID
- 17175350
- ISSN
- 0041-1345
- eISSN
- 1873-2623
- Language
- English
- Date published
- 2006
- Academic Unit
- Radiology; Gastroenterology and Hepatology; Pathology; Surgery; Internal Medicine
- Record Identifier
- 9984051532102771
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