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.

Conversion to mycophenolate mofetil for modulating recurrent hepatitis C in liver transplant recipients.

Kornberg A, Küpper B, Wilberg J, Tannapfel A, Thrum K, Bärthel E, Hommann M, Settmacher U

Department of General, Visceral and Vascular Surgery, Friedrich-Schiller-University, Jena, Germany. Arno.Kornberg@med.uni-jena.de

BACKGROUND: The aim of this study was to analyze the influence of cyclosporine A (CsA) taper in conjunction with mycophenolate mofetil (MMF) therapy on recurrent hepatitis C virus (HCV) in liver transplant patients. PATIENTS AND METHODS: Nineteen liver recipients with serologically and morphologically confirmed recurrent HCV were included in this study. After MMF introduction up to a maximum dose of 2000 mg/day, CsA dose was significantly tapered. In the control group immunosuppression remained unchanged. Allograft function and morphology, viral loads, and renal function were analyzed continuously. RESULTS: MMF treatment was well tolerated without risk of rejection. Allograft fibrosis progressed in 6 patients of the MMF group (66.6%) and none (0%) of the controls at 12-month biopsy (P=0.005). Moreover, aminotransferases and viral loads increased slightly in the MMF-treated patients. Renal function improved significantly (serum creatinine: 239.3+/-90.2 micromol/L vs. 175.8+/-46.0 micromol/L; P=0.008) in the treatment group, while deteriorating (serum creatinine: 156.8+/-44.6 micromol/L vs. 214.8+/-120.1 micromol/L; P=0.06) in the controls. CONCLUSION: MMF introduction allows a safe CsA taper in HCV-positive liver transplant patients and results in significant improvement of renal function. However, there seems to be a risk of marked progression of HCV-induced allograft injury.

Published 7 November 2007 in Transpl Infect Dis, 9(4): 295-301.
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