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Clinical outcome of patients infected with hepatitis C virus infection on survival after primary liver transplantation under tacrolimus
Author(s) -
Casavilla F. Adrian,
Rakela Jorge,
Kapur Sandip,
Irish William,
McMichael John,
Demetris Anthony J.,
Starzl Thomas E.,
Fung John J.
Publication year - 1998
Publication title -
liver transplantation and surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1074-3022
DOI - 10.1002/lt.500040605
Subject(s) - medicine , tacrolimus , immunosuppression , liver transplantation , hepatitis c virus , gastroenterology , hepatitis c , liver disease , transplantation , surgery , immunology , virus
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 (≥0.1 mg/kg/d intravenously and ≥0.2 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 (≤0.05 mg/kg/d intravenously and ≤0.1 mg/kg/d orally) is associated with a similar patient and graft survival as those without HCV infection.