title: Long-term, maintenance MMF monotherapy improves the fibrosis progression in liver transplant recipients with recurrent hepatitis C.
abstract: Hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (LT) is universal. We designed a retrospective case-control study to evaluate the effect of mycophenolate mofetil (MMF) monotherapy in patients with recurrent hepatitis C. Fifteen patients with histologically proven hepatitis C recurrence after LT were switched from calcineurin inhibitors (CNIs) to MMF monotherapy because of impairment of kidney function and/or metabolic side effects, and treated for 48 months (MMF group). Fifteen well-matched LT recipients who continued to receive CNIs therapy over the same period served as control group. Demographics, clinical data, time after LT, and baseline liver biopsies were similar in the two groups. There was no worsening of hepatic fibrosis during the study in the MMF group [2.6 ± 1.5 (baseline) Ishak Units vs. 2.7 ± 1.8 (after 48 months of MMF treatment), P = 0.6]. In contrast, a significant increase in the fibrosis score [2 ± 1.1 (baseline) vs. 3.2 ± 1.7 (after 48 months of CNI treatment), P = 0.0002] was observed in the control group. The yearly fibrosis progression rate was of 0.05 ± 0.44 in the MMF group and 0.33 ± 0.24 in the CNI group (P = 0.04). MMF monotherapy is associated with a favourable effect on hepatic fibrosis progression in HCV liver transplant recipients.
authors.affiliation: UOC Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy. tomanzia@libero.it
authors.forename: Tommaso Maria
authors.initials: TM
authors.lastname: Manzia
authors.forename: Roberta
authors.initials: R
authors.lastname: Angelico
authors.forename: Luca
authors.initials: L
authors.lastname: Toti
authors.forename: Maria Irene
authors.initials: MI
authors.lastname: Bellini
authors.forename: Daniele
authors.initials: D
authors.lastname: Sforza
authors.forename: Giampiero
authors.initials: G
authors.lastname: Palmieri
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Orlando
authors.forename: Laura
authors.initials: L
authors.lastname: Tariciotti
authors.forename: Mario
authors.initials: M
authors.lastname: Angelico
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tisone
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000494:pharmacology; D001706:Biopsy; D016022:Case-Control Studies; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005355:Fibrosis / Q000188:drug therapy* / Q000473:pathology; D006526:Hepatitis C / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D017093:Liver Failure / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000494:pharmacology; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid