title: Immunosuppression status of liver transplant recipients with hepatitis C affects biopsy-proven acute rejection.
abstract: OBJECTIVE
  The relationship between patient survival and biopsy-proven acute rejection (BPAR) in liver transplant recipients with hepatitis C remains unclear. The aims of this study were to compare the characteristics of patients with and without BPAR and to identify risk factors for BPAR.
  
  
  METHODS
  We retrospectively reviewed the records of 169 HCV-RNA-positive patients who underwent LT at three centers.
  
  
  RESULTS
  BPAR occurred in 39 (23.1%) of the HCV-RNA-positive recipients after LT. The 1-, 3-, and 5-year survival rates were 92.1%, 90.3%, and 88.5%, respectively, in patients without BPAR, and 75.7%, 63.4%, and 58.9% in patients with BPAR (P<0.001). Multivariate analyses showed that BPAR was associated with the non-use of basiliximab and tacrolimus and the use of cyclosporin in LT recipients with HCV RNA-positive.
  
  
  CONCLUSIONS
  The results of the present study suggest that the immunosuppression status of HCV-RNA-positive LT recipients should be carefully determined in order to prevent BPAR and to improve patient survival.
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul, Korea.
authors.forename: Jong Man
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kwang-Woong
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Gi-Won
authors.initials: GW
authors.lastname: Song
authors.affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Bo-Hyun
authors.initials: BH
authors.lastname: Jung
authors.affiliation: Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Hae Won
authors.initials: HW
authors.lastname: Lee
authors.affiliation: Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Nam-Joon
authors.initials: NJ
authors.lastname: Yi
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul, Korea.
authors.forename: ChoonHyuck David
authors.initials: CD
authors.lastname: Kwon
authors.affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Shin
authors.initials: S
authors.lastname: Hwang
authors.affiliation: Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kyung-Suk
authors.initials: KS
authors.lastname: Suh
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul, Korea.
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Joh
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine; Seoul, Korea.
authors.forename: Suk-Koo
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Sung-Gyu
authors.initials: SG
authors.lastname: Lee
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000077552:Basiliximab; D001706:Biopsy; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005838:Genotype; D006084:Graft Rejection / Q000401:mortality / Q000517:prevention & control*; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000188:drug therapy / Q000821:virology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000009:adverse effects; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D016559:Tacrolimus / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D012367:RNA, Viral; D011993:Recombinant Fusion Proteins; D016572:Cyclosporine; D000077552:Basiliximab; D016559:Tacrolimus
keywords: Calcineurin antagonists; Hepatitis C virus; Immunosuppression; Outcome; Rejection; Tacrolimus