Clin Mol Hepatol.
2016 Sep;22(3):366-371. 10.3350/cmh.2016.0022.
Immunosuppression status of liver transplant recipients with hepatitis C affects biopsy-proven acute rejection
- Affiliations
-
- 1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 2Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. kwleegs@gmail.com
- 3Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 4Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea.
- KMID: 2373137
- DOI: http://doi.org/10.3350/cmh.2016.0022
Abstract
- BACKGROUND/AIMS
The relationship between patient survival and biopsy-proven acute rejection (BPAR) in liver transplant recipients with hepatitis C remains unclear. The aims of this study were to compare the characteristics of patients with and without BPAR and to identify risk factors for BPAR.
METHODS
We retrospectively reviewed the records of 169 HCV-RNA-positive patients who underwent LT at three centers.
RESULTS
BPAR occurred in 39 (23.1%) of the HCV-RNA-positive recipients after LT. The 1-, 3-, and 5-year survival rates were 92.1%, 90.3%, and 88.5%, respectively, in patients without BPAR, and 75.7%, 63.4%, and 58.9% in patients with BPAR (P<0.001). Multivariate analyses showed that BPAR was associated with the non-use of basiliximab and tacrolimus and the use of cyclosporin in LT recipients with HCV RNA-positive.
CONCLUSION
The results of the present study suggest that the immunosuppression status of HCV-RNA-positive LT recipients should be carefully determined in order to prevent BPAR and to improve patient survival.
Keyword
MeSH Terms
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Antibodies, Monoclonal/therapeutic use
Biopsy
Cyclosporine/therapeutic use
Drug Therapy, Combination
Genotype
Graft Rejection/mortality/*prevention & control
Hepacivirus/genetics/isolation & purification
Hepatitis C/drug therapy/*virology
Humans
Immunosuppressive Agents/*therapeutic use
*Liver Transplantation/adverse effects
Polymerase Chain Reaction
RNA, Viral/blood
Recombinant Fusion Proteins/therapeutic use
Recurrence
Retrospective Studies
Survival Rate
Tacrolimus/therapeutic use
Antibodies, Monoclonal
Cyclosporine
Immunosuppressive Agents
RNA, Viral
Recombinant Fusion Proteins
Tacrolimus
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