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Rejection rates in a randomised trial of tacrolimus monotherapy versus triple therapy in liver transplant recipients with hepatitis C virus cirrhosis

2006; Wiley; Volume: 8; Issue: 1 Linguagem: Inglês

10.1111/j.1399-3062.2006.00124.x

1399-3062

Dimitrios Samonakis, Maria Mela, Alberto Quaglia, Christos Triantos, Ulrich Thalheimer, Gioacchino Leandro, Alberto Pesci, Massimo Raimondo, Amar P. Dhillon, Keith Rolles, Brian R Davidson, David Patch, Andrew K. Burroughs,

Liver Disease Diagnosis and Treatment

Abstract: Background. Reducing immunosuppression not only reduces complications but also may lessen recurrent hepatitis C virus (HCV) infection after liver transplantation. Patients/Methods. HCV‐infected cirrhotic patients randomised to tacrolimus monotherapy (MT) or triple therapy (TT) using tacrolimus 0.1 mg/kg/day, azathioprine 1 mg/kg/day, and prednisolone 20 mg/day, tapering over 3 months. Results. Twenty‐seven patients (MT) and 29 (TT) – median follow up 661 days (range, 1–1603). Rejection episodes (protocol/further biopsies) within first 3 months and use of empirical treatment were evaluated. New rejection was diagnosed if repeat biopsy (5‐day interval) did not show improvement. Treated rejection episodes: 20 MT (15 biopsy‐proven) vs. 24 TT (21 biopsy‐proven), with 19 (MT) vs. 24 (TT) methylprednisolone boluses. Overall: 35 episodes (MT) and 46 (TT). Fewer MT patients had histological rejection (70%) than TT patients (86%), with fewer episodes of rejection (18.5% vs. 10%), and more moderate rejection (22% vs. 41%). The MT group had higher early tacrolimus levels. Rates of renal dysfunction, retransplantation, and death were not significantly different. Conclusion. Tacrolimus monotherapy is a viable immunosuppressive strategy in HCV‐infected liver transplant recipients.