Retrospective analysis of the impact of immunosuppression on the course of recurrent hepatitis C after liver transplantation.
Transplant Proc
; 37(4): 1703-4, 2005 May.
Article
em En
| MEDLINE
| ID: mdl-15919437
ABSTRACT
INTRODUCTION:
In a substantial proportion of patients, recurrent hepatitis C after liver transplantation (OLT) rapidly progresses to graft cirrhosis. The role of different immunosuppressive schemes is not well evaluated. PATIENTS ANDMETHODS:
The clinical course of 130 patients with recurrent hepatitis C after OLT was retrospectively analyzed. Mean trough levels of calcineurin inhibitors and cumulative doses of the remaining immunosuppressants were calculated. The results were compared with liver function tests, histological fibrosis progression, and survival.RESULTS:
Survival and fibrosis progression were similar in patients with tacrolimus and cyclosporine and did not correlate with mean trough levels. In contrast, the application of azathioprine (mean dose of more than 25 mg/d during the first 3 months after OLT) was associated with significantly less progression of fibrosis (P = .01). Administration of azathioprine after the early postoperative phase was not related to the long-term outcome. The dose of prednisolone in the long-term course after OLT significantly correlated with the rate of fibrosis progression (P = .008).CONCLUSIONS:
The clinical course of recurrent hepatitis C was variable. Survival and fibrosis progression did not correlate with the type or trough level of calcineurin inhibitors. Azathioprine early in the course after OLT and prolonged administration of prednisolone were associated with less fibrosis progression.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Terapia de Imunossupressão
/
Transplante de Fígado
/
Hepatite C
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Transplant Proc
Ano de publicação:
2005
Tipo de documento:
Article