Clinical outcome of patients infected with hepatitis C virus infection on survival after primary liver transplantation under tacrolimus

✍ Scribed by Casavilla, F. Adrian ;Rakela, Jorge ;Kapur, Sandip ;Irish, William ;McMichael, John ;Demetris, Anthony J. ;Starzl, Thomas E. ;Fung, John J.

• Publisher: Wiley (John Wiley & Sons)
• Year: 1998
• Tongue: English
• Weight: 100 KB
• Volume: 4
• Category: Article
• ISSN: 1074-3022
• DOI: 10.1002/lt.500040605

✦ Synopsis

The outcome of hepatitis C virus (HCV) infection on patient and graft survival after orthotopic liver transplantation (OLT) has been controversial. An earlier experience with a higher dose of tacrolimus (H0.1 mg/kg/d intravenously and H0.2 mg/ kg/d orally) was associated with a worse clinical outcome in patients infected with HCV. The clinical outcome of 183 liver transplant recipients with end-stage liver disease (ESLD) secondary to HCV infection (HCV group) was compared with a contemporary cohort of 556 patients with HCV infection who underwent transplantation for nonviral, nonmalignant ESLD (control group). All patients were prospectively screened for anti-HCV antibodies and HCV RNA by reverse-transcriptase polymerase chain reaction. All OLT patients were receiving low-dose tacrolimus immunosuppression. Cumulative patient survival rates for the HCV group were 80% after 1 year and 75% after 3 years compared with rates of 84% and 78%, respectively, in the control group (P ‫؍‬ .452). Primary graft survival rates at the same time intervals for the HCV group and the control group were 72% and 77.5% at 1 year and 67% and 72% at 3 years, respectively (P ‫؍‬ .144). The incidence of re-transplantation (re-OLT) in the HCV group and the control group was 12.6% and 10.4%, respectively (P ‫؍‬ .42). Chronic HCV infection as an indication for OLT with a lower dose of tacrolimus immunosuppression (I0.05 mg/kg/d intravenously and I0.1 mg/kg/d orally) is associated with a similar patient and graft survival as those without HCV infection.