Original Article

Digestive Diseases and Sciences

, Volume 57, Issue 2, pp 568-572

First online:

Impact of Calcineurin Inhibitors on Hepatitis C Recurrence After Liver Transplantation

  • Robin D. KimAffiliated withSection of Transplantation, Department of Surgery, University of Utah School of Medicine Email author 
  • , Shugo MizunoAffiliated withDepartment of Surgery, Division of Transplantation, University of Florida College of Medicine, M-125 Health Science Center
  • , John B. SorensenAffiliated withSection of Transplantation, Department of Surgery, University of Utah School of Medicine
  • , Jason J. SchwartzAffiliated withSection of Transplantation, Department of Surgery, University of Utah School of Medicine
  • , Shiro FujitaAffiliated withDepartment of Surgery, Division of Transplantation, University of Florida College of Medicine, M-125 Health Science Center

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Abstract

Background and Aims

The aim of this retrospective study is to assess the impact of calcineurin inhibitors on hepatitis C virus recurrence following liver transplantation.

Methods

A total of 396 patients underwent liver transplantation for hepatitis C virus-induced liver disease between 1991 and 2005 at a single center. We examined the pre- and post-operative characteristics of patients who received either cyclosporine (n = 126) or tacrolimus (n = 270) as maintenance immunosuppression. In addition, we compared the postoperative course, including patient, graft and hepatitis C virus recurrence-free survival between the two groups.

Results

There were no significant differences between the two groups in either post-operative hepatitis C virus—ribonucleic acid or histological fibrosis score (performed within 6 months after transplant per protocol). The graft and patient survivals did not differ between the two groups (logrank p = 0.34 and 0.15, respectively). Histologic hepatitis C virus recurrence-free survival, however, was significantly higher in the cyclosporine group than in the tacrolimus group (55.4 vs. 30.8% at 1 year, 18.6 vs. 10.3% at 3 years, 16.7 vs. 8.1% at 5 years, p < 0.001).

Conclusions

Patients transplanted for hepatitis C virus and treated with cyclosporine versus tacrolimus may have a higher recurrence-free survival.

Keywords

Calcineurin inhibitors Hepatitis C recurrence Liver transplantation