Results of a two-center study comparing hepatic fibrosis progression in HCV-positive liver transplant patients receiving cyclosporine or tacrolimus
A 2-center retrospective analysis was performed in 60 patients undergoing liver transplantation for hepatitis C virus (HCV)related disease (cyclosporine in 20, tacrolimus in 40). Mean (±SEM) follow-up was 23.6 ± 22.5 and 22.3 ± 13.7 months in patients receiving cyclosporine or tacrolimus, respectively. Clinically indicated biopsies were performed in 15/20 cyclosporine patients (75%) and 22/40 tacrolimus patients (55%; P = .17). The Ishak fibrosis score was significantly lower in cyclosporine-treated patients versus tacrolimus-treated patients (mean 1.7 ± 0.4 vs 3.1 ± 0.4; P = .023), as was percentage of fibrosis grade Ishak <4 (7% vs 41%; P = .028). The mean time to moderate fibrosis (Ishak score <3) was 38.2 ± 15.1 months in cyclosporine patients (4/15) and 23.5 ± 12.6 months in tacrolimus patients (14/22); the difference was not statistically significant (P = .09). This retrospective study suggests that cyclosporine-based immunosuppression is associated with less severe hepatic fibrosis in HCV-positive liver transplant recipients compared with tacrolimus-based regimens, but a larger prospective comparative trial is necessary to confirm these findings.
|Keywords||adult, antiviral therapy, antivirus agent, azathioprine, calcineurin inhibitor, conference paper, controlled study, corticosteroid, cyclosporin A, disease course, female, follow up, graft recipient, hepatitis C, human, human tissue, immunosuppressive treatment, liver biopsy, liver fibrosis, liver graft rejection, liver transplantation, low drug dose, major clinical study, male, priority journal, retrospective study, tacrolimus, treatment duration|
|Persistent URL||dx.doi.org/10.1016/j.transproceed.2010.10.013, hdl.handle.net/1765/22962|
van der Laan, L.J.W., Hudson, M.P., McPherson, S., Zondervan, P.E., Thomas, R.C., Kwekkeboom, J., … Metselaar, H.J.. (2010). Results of a two-center study comparing hepatic fibrosis progression in HCV-positive liver transplant patients receiving cyclosporine or tacrolimus. Transplantation Proceedings, 42(10), 4573–4577. doi:10.1016/j.transproceed.2010.10.013