Complete weaning off immunosuppression in HCV liver transplant recipients is feasible and favourably impacts on the progression of disease recurrence

Giuseppe Tisone, Giuseppe Orlando, Andrea Cardillo, Giampiero Palmieri, Tommaso Maria Manzia, Leonardo Baiocchi, Raffaella Lionetti, Alessandro Anselmo, Luca Toti, Mario Angelico

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aims: HCV-related disease recurrence progresses rapidly after liver transplantation. We hypothesised that withdrawal of immunosuppression might favourably impact on disease progression. Methods: Weaning off immunosuppression was attempted in 34 HCV-RNA positive patients (mean age 62±6.4 years) transplanted 63.5±20.1 months earlier, under cyclosporine A monotherapy. Patients were followed for 3 years including yearly protocol liver biopsies. Primary endpoints were feasibility of weaning off immunosuppression and its impact on disease progression. Secondary endpoint was to identify predictors of an immunosuppression-free state and fibrosis progression. Results: Complete and permanent immunosuppression withdrawal was achieved in 8 patients (23.4%), whereas 14 (41.2%) developed rejection within eight months despite an initial response and 12 (35.2%) rejected during tapering. After a mean follow-up 45.5±5.8 months weaned patients showed stabilisation/improvement of histological fibrosis (P

Original languageEnglish
Pages (from-to)702-709
Number of pages8
JournalJournal of Hepatology
Volume44
Issue number4
DOIs
Publication statusPublished - Apr 2006

Keywords

  • Cyclosporine A withdrawal
  • Disease recurrence
  • Fibrosis
  • Staging
  • Tolerance

ASJC Scopus subject areas

  • Gastroenterology

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