title: The Tor Vergata weaning of immunosuppression protocols in stable hepatitis C virus liver transplant patients: the 10-year follow-up.
abstract: We report herein the 10-year outcome of the Tor Vergata weaning off immunosuppression protocol in hepatitis C virus (HCV) liver transplant patients. Thirty-four patients who had received a liver graft for HCV-related cirrhosis were enrolled in a prospective study in which they were progressively weaned off immunosuppression. The primary endpoints were feasibility and safety of the weaning; the second aim was to assess fibrosis progression. At the 10-year follow-up, of the eight original tolerant patients, six remained IS-free. Of the 26 individuals who could not be weaned, 22 were alive. When the baseline biopsies were compared with the 10-year biopsies, the tolerant group showed no differences in staging, whereas the nontolerant group showed a significant increase in staging. The fibrosis progression rates calculated for the tolerant and the nontolerant groups were -0.06 ± 0.12 and 0.1 ± 0.2, respectively (P = 0.04). Furthermore, with the last taken biopsies, nine nontolerant patients were showing frank cirrhosis versus no cirrhosis among the tolerant patients. After a 10-year follow-up of a Tor Vergata weaning protocol, 6/34 patients completed follow-up without reinstitution of immunosuppression and this appeared beneficial regarding a reduction in fibrosis progression.
authors.affiliation: UOC Trapianti d'Organo, Tor Vergata University, Rome 00144, 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: Leonardo
authors.initials: L
authors.lastname: Baiocchi
authors.forename: Luca
authors.initials: L
authors.lastname: Toti
authors.forename: Paolo
authors.initials: P
authors.lastname: Ciano
authors.forename: Giampiero
authors.initials: G
authors.lastname: Palmieri
authors.forename: Mario
authors.initials: M
authors.lastname: Angelico
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Orlando
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tisone
mesh_terms: D000367:Age Factors; D000368:Aged; D001707:Biopsy, Needle; D015331:Cohort Studies; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D019698:Hepatitis C, Chronic / Q000473:pathology / Q000601:surgery*; D006785:Hospitals, University; D006801:Humans; D007150:Immunohistochemistry; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000473:pathology / Q000601:surgery* / Q000821:virology*; D016031:Liver Transplantation / Q000276:immunology* / Q000379:methods / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012384:Rome; D012737:Sex Factors; D016019:Survival Analysis; D013997:Time Factors; D014181:Transplantation Immunology; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents