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.

, , , , , , , , , , , , , , , , , , , , , , , , , , ,
doi.org/10.1016/j.transproceed.2010.10.013, hdl.handle.net/1765/22962
Transplantation Proceedings
Erasmus MC: University Medical Center Rotterdam

van der Laan, L., Hudson, M. P., McPherson, S., Zondervan, P., Thomas, R. C., Kwekkeboom, J., … Metselaar, H. (2010). Results of a two-center study comparing hepatic fibrosis progression in HCV-positive liver transplant patients receiving cyclosporine or tacrolimus. In Transplantation Proceedings (Vol. 42, pp. 4573–4577). doi:10.1016/j.transproceed.2010.10.013