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Minimization of immunosuppression with thymoglobuline pre‐treatment and HCV recurrence in liver transplantation
Author(s) -
Ruvo Nicola De,
Cucchetti Alessandro,
Lauro Augusto,
Masetti Michele,
Benedetto Fabrizio Di,
Cautero Nicola,
Barba Giuliano La,
Dazzi Alessandro,
Francesco Fabrizio Di,
Molteni Gabriele,
Romano Antonio,
Ramacciato Giovanni,
Risaliti Andrea,
Pinna Antonio Daniele
Publication year - 2005
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2005.00333.x
Subject(s) - immunosuppression , medicine , liver transplantation , hepatitis c virus , transplantation , immunology , hepatitis c , gastroenterology , hepacivirus , surgery , virus
Induction with thymoglobuline, a potent anti‐thymocyte polyclonal antibody, has been recently reported to allow minimization of postoperative immunosuppression in organ transplantation. The relationship with recurrence of hepatitis C virus (HCV) after liver transplantation (LTx) has never been investigated. We report here on the outcome in 22 HCV+ patients receiving thymoglobuline pre‐treatment and minimal immunosuppression after LTx. Patient survival and acute rejection rates were good, and remarkably low dosages and levels of immunosuppression were achieved with thymoglobuline, without exposing patients to an elevated risk of rejection. A progressive weaning of the primary immunosuppressor was also possible in the majority of patients without complications. The HCV recurrence rate was similar to what is reported in the literature, although lower HCV‐RNA viral loads were obtained with thymoglobuline, with a mild histologic course. Although our results need to be validated in large cohort studies, our experience shows that minimization of immunosuppression with thymoglobuline is effective in protecting against rejection and demonstrated a positive impact on HCV recurrence that deserves further investigation.