title: Curing Hepatitis C in Liver Transplant Recipients Is Associated with Changes in Immunosuppressant Use.
abstract: OBJECTIVE
  All-oral interferon-free antivirals are highly effective in treating recurrent hepatitis C (HCV) infection in liver transplant (LT) recipients. The aim of the study was to assess immunosuppression needs after achieving a sustained viral response (SVR).
  
  
  METHODS
  We compared immunosuppression needs before and after achieving a SVR in adult LT recipients treated for recurrent HCV infection with all-oral direct acting agents.
  
  
  RESULTS
  We identified 52 liver LT treated recipients who achieved a SVR. The median (25th and 75th percentile interquartile range [IQR]) age was 62 years (57.75, 65). Most recipients received tacrolimus (TAC) for their immunosuppressant regimen. After achieving SVR, there was no statistically significant difference in daily dose of TAC unadjusted per weight (p > 0.05). However, there was a statistically significant decrease in daily dose of TAC adjusted per weight, serum levels of TAC, and the product of glomerular filtration rate and TAC. No statistically significant differences in cyclosporine unadjusted/adjusted per weight daily dose or serum levels were noted.
  
  
  CONCLUSIONS
  Immunosuppression needs were increased for those patients treated with TAC but not cyclosporine. LT recipients prescribed TAC require close monitoring after treatment completion to avoid potential risk of acute rejection.
authors.affiliation: Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA; Department of Surgery at the University of California at Los Angeles, Los Angeles, California, USA.
authors.forename: Sammy
authors.initials: S
authors.lastname: Saab
authors.affiliation: Department of Medicine at Harbor-University of California at Los Angeles Medical Center, Torrance, California, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: Rheem
authors.affiliation: Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Jimenez
authors.affiliation: Department of Surgery at the University of California at Los Angeles, Los Angeles, California, USA.
authors.forename: Sherona
authors.initials: S
authors.lastname: Bau
authors.affiliation: Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA; Department of Surgery at the University of California at Los Angeles, Los Angeles, California, USA.
authors.forename: Gina
authors.initials: G
authors.lastname: Choi
authors.affiliation: Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA; Department of Surgery at the University of California at Los Angeles, Los Angeles, California, USA.
authors.forename: Francisco
authors.initials: F
authors.lastname: Durazo
authors.affiliation: Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA; Department of Surgery at the University of California at Los Angeles, Los Angeles, California, USA.
authors.forename: Mohammed
authors.initials: M
authors.lastname: El Kabany
authors.affiliation: Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA; Department of Surgery at the University of California at Los Angeles, Los Angeles, California, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Han
authors.affiliation: Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Farid
authors.affiliation: Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA.
authors.forename: Naadir
authors.initials: N
authors.lastname: Jamal
authors.affiliation: Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Grotts
authors.affiliation: Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA; Department of Biostatistics at the University of California at Los Angeles, Los Angeles, California, USA.
authors.forename: David
authors.initials: D
authors.lastname: Elashoff
authors.affiliation: Department of Surgery at the University of California at Los Angeles, Los Angeles, California, USA.
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Busuttil
keywords: Direct acting agents; Hepatitis C; Immunosuppressant; Liver transplantation