title: Influence of steroids on HCV recurrence after liver transplantation: A prospective study.
abstract: OBJECTIVE
  To assess the effect of long-term maintenance of steroids on HCV recurrence after liver transplantation (LT), that is still controversial, a prospective multicentre trial was conducted at the centres of Bologna and Padua, Italy.
  
  
  METHODS
  From September 2002, 47 eligible HCV positive LT recipients were randomized to receive 2 different steroid schedules in association with tacrolimus: group A: rapid tapering and withdrawal 91 days after LT group B: slow tapering and withdrawal 25 months after LT. Thirty-nine patients were assessable: 23 in group A and 16 in group B. Donor and recipient characteristics were similar in the two groups. Median follow-up was 841 days (130-1376). One hundred liver biopsies were performed, and every patient had a biopsy at month 12.
  
  
  RESULTS
  Twenty-two out of 23 (95, 65%) patients in group A and 15 out of 16 (93, 75%) in group B had histologically-confirmed HCV recurrence. Twelve-month histology showed advanced fibrosis (score 3 or 4) in 42.1% of the patients in group A versus 7.6% in group B (P=0.03). One-and 2-year advanced fibrosis-free survival were 65.2 and 60.8 in group A and 93.7% in group B (P=0.03 and =0.02, respectively).
  
  
  CONCLUSIONS
  Slow tapering of steroids reduced the progression of recurrent hepatitis C after LT.
authors.affiliation: Department of Surgery and Transplantation, University of Bologna, Italy. vivarelli@aosp.bo.it
authors.forename: Marco
authors.initials: M
authors.lastname: Vivarelli
authors.forename: Patrizia
authors.initials: P
authors.lastname: Burra
authors.forename: Giuliano
authors.initials: G
authors.lastname: La Barba
authors.forename: Daniele
authors.initials: D
authors.lastname: Canova
authors.forename: Marco
authors.initials: M
authors.lastname: Senzolo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cucchetti
authors.forename: Antonia
authors.initials: A
authors.lastname: D'Errico
authors.forename: Maria
authors.initials: M
authors.lastname: Guido
authors.forename: Roberto
authors.initials: R
authors.lastname: Merenda
authors.forename: Daniele
authors.initials: D
authors.lastname: Neri
authors.forename: Matteo
authors.initials: M
authors.lastname: Zanello
authors.forename: Federico Maria
authors.initials: FM
authors.lastname: Giannini
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Grazi
authors.forename: Umberto
authors.initials: U
authors.lastname: Cillo
authors.forename: Antonio Daniele
authors.initials: AD
authors.lastname: Pinna
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006526:Hepatitis C / Q000188:drug therapy* / Q000209:etiology* / Q000401:mortality; D006801:Humans; D008103:Liver Cirrhosis; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D055502:Secondary Prevention; D013256:Steroids / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013256:Steroids; D011241:Prednisone