Liver transplantationOutcomeResults of a Two-Center Study Comparing Hepatic Fibrosis Progression in HCV-positive Liver Transplant Patients Receiving Cyclosporine or Tacrolimus
Section snippets
Methods
In this retrospective study, data were examined from a sequential series of patients undergoing liver transplantation for HCV-related liver disease at 2 centers. All patients receiving a primary liver transplant during the period 1993–2005 who had a follow-up of ≥1 year were eligible for inclusion. Maintenance immunosuppression at both centers comprised either CsA or tacrolimus and corticosteroids, with or without azathioprine. Liver biopsy was performed on clinical indication in response to
Results
In total, 60 patients underwent transplantation for HCV-related disease during the period 1993–2005, of whom 38 were transplanted at Rotterdam and 22 in Newcastle. Of these, 20 (33.3%) received CsA and 40 (66.6%) received tacrolimus. Mean follow-up was 23.6 ± 22.5 months (range, 3–82 months) in the CsA-treated group and 22.3 ± 13.7 months in the tacrolimus-treated group (range, 3–55 months). All patients received low-dose corticosteroids during the first 6 months after transplantation. The
Discussion
Results from this retrospective 2-center analysis indicate that despite similar recipient and donor characteristics, HCV-positive liver transplantation patients given a CsA-based regimen experience less severe hepatic fibrosis progression then those given tacrolimus, and that development of fibrosis is delayed. Of note, cirrhosis developed only in patients receiving tacrolimus. The increased fibrosis seen in tacrolimus-treated patients appeared independent of PTDM and was also observed in
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