Digestive Diseases and Sciences

, Volume 57, Issue 2, pp 568–572 | Cite as

Impact of Calcineurin Inhibitors on Hepatitis C Recurrence After Liver Transplantation

  • Robin D. Kim
  • Shugo Mizuno
  • John B. Sorensen
  • Jason J. Schwartz
  • Shiro Fujita
Original Article


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.


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.


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).


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


Calcineurin inhibitors Hepatitis C recurrence Liver transplantation 


  1. 1.
    Neumann UP, Berg T, Bahra M, et al. Long-term outcome of liver transplants for chronic hepatitis C: a 10-year follow-up. Transplantation. 2004;77:226–231.PubMedCrossRefGoogle Scholar
  2. 2.
    Forman LM, Lewis JD, Berlin JA, Feldman HI, Lucey MR. The association between hepatitis C infection and survival after orthotopic liver transplantation. Gastroenterology. 2002;122:889–896.PubMedCrossRefGoogle Scholar
  3. 3.
    Berenguer M, Ferrell L, Watson J, et al. HCV-related fibrosis progression following liver transplantation: increase in recent years. J Hepatol. 2000;32:673–684.PubMedCrossRefGoogle Scholar
  4. 4.
    Lake JR. The role of immunosuppression in recurrence of hepatitis C. Liver Transpl. 2003;9:S63–S66.PubMedCrossRefGoogle Scholar
  5. 5.
    Martin P, Busuttil RW, Goldstein RM, et al. Impact of tacrolimus versus cyclosporine in hepatitis C virus-infected liver transplant recipients on recurrent hepatitis: a prospective, randomized trial. Liver Transpl. 2004;10:1258–1262.PubMedCrossRefGoogle Scholar
  6. 6.
    Berenguer M, Aguilera V, Prieto M, et al. Effect of calcineurin inhibitors on survival and histologic disease severity in HCV-infected liver transplant recipients. Liver Transpl. 2006;12:762–767.PubMedCrossRefGoogle Scholar
  7. 7.
    Watashi K, Hijikata M, Hosaka M, Yamaji M, Shimotohno K. Cyclosporin A suppresses replication of hepatitis C virus genome in cultured hepatocytes. Hepatology. 2003;38:1282–1288.PubMedCrossRefGoogle Scholar
  8. 8.
    Inoue K, Sekiyama K, Yamada M, Watanabe T, Yasuda H, Yoshiba M. Combined interferon alpha2b and cyclosporin A in the treatment of chronic hepatitis C: controlled trial. J Gastroenterol. 2003;38:567–572.PubMedGoogle Scholar
  9. 9.
    Ishak K, Baptista A, Bianchi L, et al. Histological grading and staging of chronic hepatitis. J Hepatol. 1995;22:696–699.PubMedCrossRefGoogle Scholar
  10. 10.
    Berenguer M, Lopez-Labrador FX, Wright TL. Hepatitis C and liver transplantation. J Hepatol. 2001;35:666–678.PubMedCrossRefGoogle Scholar
  11. 11.
    Berenguer M, Prieto M, San Juan F, et al. Contribution of donor age to the recent decrease in patient survival among HCV-infected liver transplant recipients. Hepatology. 2002;36:202–210.PubMedCrossRefGoogle Scholar
  12. 12.
    Levy G, Grazi GL, Sanjuan F, et al. 12-month follow-up analysis of a multicenter, randomized, prospective trial in de novo liver transplant recipients (LIS2T) comparing cyclosporine microemulsion (C2 monitoring) and tacrolimus. Liver Transpl. 2006;12:1464–1472.PubMedCrossRefGoogle Scholar
  13. 13.
    Yoshizawa A, Takada Y, Fujimoto Y, et al. Liver transplantation from an identical twin without immunosuppression, with early recurrence of hepatitis C. Am J Transpl. 2006;6:2812–2816.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Robin D. Kim
    • 1
  • Shugo Mizuno
    • 2
  • John B. Sorensen
    • 1
  • Jason J. Schwartz
    • 1
  • Shiro Fujita
    • 2
  1. 1.Section of Transplantation, Department of SurgeryUniversity of Utah School of MedicineSalt Lake CityUSA
  2. 2.Department of Surgery, Division of TransplantationUniversity of Florida College of Medicine, M-125 Health Science CenterGainesvilleUSA

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