title: Results of a two-center study comparing hepatic fibrosis progression in HCV-positive liver transplant patients receiving cyclosporine or tacrolimus.
abstract: A 2-center retrospective analysis was performed in 60 patients undergoing liver transplantation for hepatitis C virus (HCV)-related disease (cyclosporine in 20, tacrolimus in 40). Mean (±SEM) follow-up was 23.6 ± 22.5 and 22.3 ± 13.7 months in patients receiving cyclosporine or tacrolimus, respectively. Clinically indicated biopsies were performed in 15/20 cyclosporine patients (75%) and 22/40 tacrolimus patients (55%; P = .17). The Ishak fibrosis score was significantly lower in cyclosporine-treated patients versus tacrolimus-treated patients (mean 1.7 ± 0.4 vs 3.1 ± 0.4; P = .023), as was percentage of fibrosis grade Ishak ≥4 (7% vs 41%; P = .028). The mean time to moderate fibrosis (Ishak score ≥3) was 38.2 ± 15.1 months in cyclosporine patients (4/15) and 23.5 ± 12.6 months in tacrolimus patients (14/22); the difference was not statistically significant (P = .09). This retrospective study suggests that cyclosporine-based immunosuppression is associated with less severe hepatic fibrosis in HCV-positive liver transplant recipients compared with tacrolimus-based regimens, but a larger prospective comparative trial is necessary to confirm these findings.
authors.affiliation: Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: L J W
authors.initials: LJ
authors.lastname: van der Laan
authors.forename: M
authors.initials: M
authors.lastname: Hudson
authors.forename: S
authors.initials: S
authors.lastname: McPherson
authors.forename: P E
authors.initials: PE
authors.lastname: Zondervan
authors.forename: R C
authors.initials: RC
authors.lastname: Thomas
authors.forename: J
authors.initials: J
authors.lastname: Kwekkeboom
authors.forename: A S
authors.initials: AS
authors.lastname: Lindsay
authors.forename: A D
authors.initials: AD
authors.lastname: Burt
authors.forename: G
authors.initials: G
authors.lastname: Kazemier
authors.forename: H W
authors.initials: HW
authors.lastname: Tilanus
authors.forename: M F
authors.initials: MF
authors.lastname: Bassendine
authors.forename: H J
authors.initials: HJ
authors.lastname: Metselaar
mesh_terms: D016572:Cyclosporine / Q000008:administration & dosage*; D018450:Disease Progression; D005260:Female; D006526:Hepatitis C / Q000601:surgery*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008103:Liver Cirrhosis / Q000503:physiopathology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016559:Tacrolimus / Q000008:administration & dosage*
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus