Impact of tacrolimus versus cyclosporine in hepatitis C virus-infected liver transplant recipients on recurrent hepatitis

A prospective, randomized trial

Paul Martin, Ronald W. Busuttil, Robert M. Goldstein, Jeffrey S. Crippin, Goran B. Klintmalm, William E. Fitzsimmons, Carol Uleman

Research output: Contribution to journalArticle

110 Citations (Scopus)

Abstract

Hepatitis C virus (HCV)-induced cirrhosis is the commonest indication for orthotopic liver transplantation, but HCV recurrence is nearly universal and may worsen patient / graft outcomes. The frequency and severity of HCV recurrence has apparently increased in recent years, raising concern about a possible role for newer immunosuppression regimens in this increase, including potentially tacrolimus. We randomized 79 patients to receive tacrolimus or cyclosporine as primary immunosuppressant posttransplantation. A pathologist blinded to treatment reviewed serial liver biopsies. Month 12 cumulative probabilities of histological hepatitis C recurrence for tacrolimus- and cyclosporine-treated patients were .38 and .54 (P = .19) and failure / death were .25 and .28, respectively (P = .789). Although cyclosporine-treated patients had significantly larger increases in median serum HCV RNA levels (months 1, 6, and 12), no significant differences were observed between the two treatment arms in histologically-diagnosed HCV recurrence / survival rates. In conclusion, choice of calcineurin inhibitors does not impact severity of recurrent HCV.

Original languageEnglish
Pages (from-to)1258-1262
Number of pages5
JournalLiver Transplantation
Volume10
Issue number10
DOIs
StatePublished - Oct 1 2004
Externally publishedYes

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Tacrolimus
Hepacivirus
Cyclosporine
Hepatitis
Liver
Recurrence
Immunosuppressive Agents
Hepatitis C
Liver Transplantation
Immunosuppression
Transplant Recipients
Arm
Fibrosis
Survival Rate
RNA
Transplants
Biopsy
Therapeutics
Serum

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Impact of tacrolimus versus cyclosporine in hepatitis C virus-infected liver transplant recipients on recurrent hepatitis : A prospective, randomized trial. / Martin, Paul; Busuttil, Ronald W.; Goldstein, Robert M.; Crippin, Jeffrey S.; Klintmalm, Goran B.; Fitzsimmons, William E.; Uleman, Carol.

In: Liver Transplantation, Vol. 10, No. 10, 01.10.2004, p. 1258-1262.

Research output: Contribution to journalArticle

Martin, Paul ; Busuttil, Ronald W. ; Goldstein, Robert M. ; Crippin, Jeffrey S. ; Klintmalm, Goran B. ; Fitzsimmons, William E. ; Uleman, Carol. / Impact of tacrolimus versus cyclosporine in hepatitis C virus-infected liver transplant recipients on recurrent hepatitis : A prospective, randomized trial. In: Liver Transplantation. 2004 ; Vol. 10, No. 10. pp. 1258-1262.
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