title: Cyclosporin A, but not tacrolimus, negatively affects the hepatic extraction fraction of hepatobiliary scintigraphy in liver transplant recipients.
abstract: BACKGROUND
  Hepatobiliary scintigraphy using (99m)Tc-mebrofenin has been used as an investigation to study liver function after liver transplantation (LTx). Hepatic extraction fraction (HEF) is a measurement of the hepatic extraction efficiency and hepatic extraction rate. With the purpose of evaluating a possible diverging effect of cyclosporin A (CSA) and tacrolimus (TAC) on the HEF, we compared the HEF with biochemical and histological parameters in LTx patients receiving either CSA or TAC.
  
  
  METHODS
  Thirty-nine adult patients who underwent LTx due to hepatitis C virus (HCV) cirrhosis were evaluated. All patients underwent a 3-month and 1-year follow-up that included hepatobiliary scintigraphy and biochemistry tests. Liver biopsy was performed at 1 year. These clinical parameters were compared between the two groups, TAC (n = 15) and CSA (n = 24).
  
  
  RESULTS
  The average HEF was significantly lower in the CSA group compared to the TAC group both at 3 months and 1 year after LTx. The liver biochemistry tests, average donor and recipient age, average cold ischemia time (CIT), and a clearance were comparable in the two groups. The TAC group had more inflammation than the CSA group. Moreover, three patients who converted from CSA to TAC increased their HEF values.
  
  
  CONCLUSIONS
  CSA-treated patients presented a lower HEF value on hepatobiliary scintigraphy in spite of comparable liver function by traditional measurements indicating a decrease on HEF values by CSA.
authors.affiliation: Division of Transplantation Surgery and CLINTEC, Karolinska University Hospital, Huddinge, and Karolinska Institutet, Stockholm, Sweden, anastasios.kaxiras@karolinska.se.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Kaxiras
authors.forename: Shinji
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Gunnar
authors.initials: G
authors.lastname: Söderdahl
authors.forename: Annika
authors.initials: A
authors.lastname: Wernerson
authors.forename: Rimma
authors.initials: R
authors.lastname: Axelsson
authors.forename: Bo-Göran
authors.initials: BG
authors.lastname: Ericzon