Rejection rates in a randomised trial of tacrolimus monotherapy versus triple therapy in liver transplant recipients with hepatitis C virus cirrhosis

D. N. Samonakis, M. Mela, A. Quaglia, C. K. Triantos, U. Thalheimer, G. Leandro, A. Pesci, M. L. Raimondo, A. P. Dhillon, K. Rolles, B. R. Davidson, D. W. Patch, A. K. Burroughs

Research output: Contribution to journalArticle

Abstract

Background. Reducing immunosuppression not only reduces complications but also may lessen recurrent hepatitis C virus (HCV) infection after liver transplantation. Patients/Methods. HCV-infected cirrhotic patients randomised to tacrolimus monotherapy (MT) or triple therapy (TT) using tacrolimus 0.1 mg/kg/day, azathioprine 1 mg/kg/day, and prednisolone 20 mg/day, tapering over 3 months. Results. Twenty-seven patients (MT) and 29 (TT) - median follow up 661 days (range, 1-1603). Rejection episodes (protocol/further biopsies) within first 3 months and use of empirical treatment were evaluated. New rejection was diagnosed if repeat biopsy (5-day interval) did not show improvement. Treated rejection episodes: 20 MT (15 biopsy-proven) vs. 24 TT (21 biopsy-proven), with 19 (MT) vs. 24 (TT) methylprednisolone boluses. Overall: 35 episodes (MT) and 46 (TT). Fewer MT patients had histological rejection (70%) than TT patients (86%), with fewer episodes of rejection (18.5% vs. 10%), and more moderate rejection (22% vs. 41%). The MT group had higher early tacrolimus levels. Rates of renal dysfunction, retransplantation, and death were not significantly different. Conclusion. Tacrolimus monotherapy is a viable immunosuppressive strategy in HCV-infected liver transplant recipients.

Original languageEnglish
Pages (from-to)3-12
Number of pages10
JournalTransplant Infectious Disease
Volume8
Issue number1
DOIs
Publication statusPublished - Mar 2006

Keywords

  • Cirrhosis
  • Hepatitis C
  • Liver transplantation
  • Randomised trial
  • Tacrolimus monotherapy

ASJC Scopus subject areas

  • Transplantation
  • Microbiology (medical)
  • Immunology

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