Immunosuppression status of liver transplant recipients with hepatitis C affects biopsy-proven acute rejection

• Published in: Clinical and molecular hepatology Vol. 22; no. 3; pp. 366 - 371
• Main Authors: Kim, Jong Man, Lee, Kwang-Woong, Song, Gi-Won, Jung, Bo-Hyun, Lee, Hae Won, Yi, Nam-Joon, Kwon, ChoonHyuck David, Hwang, Shin, Suh, Kyung-Suk, Joh, Jae-Won, Lee, Suk-Koo, Lee, Sung-Gyu
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Association for the Study of the Liver 01.09.2016; Korean Association for the Study of the Liver; 대한간학회
• Subjects: Antibodies, Monoclonal - therapeutic use; Biopsy; Calcineurin antagonists; Cyclosporine - therapeutic use; Drug Therapy, Combination; Genotype; Graft Rejection - mortality; Graft Rejection - prevention & control; Hepacivirus - genetics; Hepacivirus - isolation & purification; Hepatitis C - drug therapy; Hepatitis C - virology; Hepatitis C virus; Humans; Immunosuppression; Immunosuppressive Agents - therapeutic use; Liver Transplantation - adverse effects; Original; Outcome; Polymerase Chain Reaction; Recombinant Fusion Proteins - therapeutic use; Recurrence; Rejection; Retrospective Studies; RNA, Viral - blood; Survival Rate; Tacrolimus; Tacrolimus - therapeutic use; 내과학; Rejection; Immunosuppression; Calcineurin antagonists; Tacrolimus; Hepatitis C virus; Outcome
• ISSN: 2287-2728; 2287-285X
• DOI: 10.3350/cmh.2016.0022

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. We retrospectively reviewed the records of 169 HCV-RNA-positive patients who underwent LT at three centers. 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 ( <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. 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.