Organ Transplantation Research Today is a free monthly online journal that collates and summarizes the latest research about Organ Transplantation, including details on risks, prognosis, procedure, surgery.

MMF and calcineurin taper in recurrent hepatitis C after liver transplantation: impact on histological course.

Bahra M, Neumann UI, Jacob D, Puhl G, Klupp J, Langrehr JM, Berg T, Neuhaus P

Medizinischa Klinik mit Schwerpunht, Hepatologie, Gastroentorologie, Universitätsklinikum Charité and Campus Virchow-Klinikum, Humboldt-Universität, Berlin, Germany. marcus.bahra@charite.de

Hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (OLT) is almost universal. The optimal immunosuppression for these patients is still under discussion. We designed a retrospective case-control study to evaluate the effect of mycophenolate mofetil (MMF) treatment in patients with recurrent hepatitis C. Forty patients with histologically proven hepatitis C recurrence after OLT were treated with MMF and calcineurin inhibitor (CNI) taper for 24 months and matched with 40 non-MMF-treated positive liver transplant recipients. Liver biopsies were obtained prior to MMF treatment and after a mean follow-up of 24 months. Histological changes were evaluated utilizing the Metavir score. Comparison of fibrosis/inflammation showed no impairment of histological findings during MMF treatment. In contrast, histological findings of the 40 non-MMF patients showed a significant increase of severity for inflammation/fibrosis. Viral load was similar in both groups. The course of alanin amino transferase (ALT) levels measured during MMF treatment showed a significant decrease. MMF in combination with CNI taper showed a positive effect on fibrosis progression, graft inflammation and ALT levels and may improve the clinical course of HCV after OLT, however, the antiviral properties of MMF are still unconfirmed.

Published 12 January 2005 in Am J Transplant, 5(2): 406-11.
Full-text of this article is available online (may require subscription).

© 2004-2008 Organ Transplantation Research Today. All Rights Reserved.