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J Clin Transl Hepatol. 2016 Mar 28;4(1):32-8. doi: 10.14218/JCTH.2016.00001. Epub 2016 Mar 15.

Curing Hepatitis C in Liver Transplant Recipients Is Associated with Changes in Immunosuppressant Use.

Author information

1
Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA; Department of Surgery at the University of California at Los Angeles, Los Angeles, California, USA.
2
Department of Medicine at Harbor-University of California at Los Angeles Medical Center, Torrance, California, USA.
3
Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA.
4
Department of Surgery at the University of California at Los Angeles, Los Angeles, California, USA.
5
Departments of Medicine at the University of California at Los Angeles, Los Angeles, California, USA; Department of Biostatistics at the University of California at Los Angeles, Los Angeles, California, USA.

Abstract

BACKGROUND AND AIMS:

All-oral interferon-free antivirals are highly effective in treating recurrent hepatitis C (HCV) infection in liver transplant (LT) recipients. The aim of the study was to assess immunosuppression needs after achieving a sustained viral response (SVR).

METHODS:

We compared immunosuppression needs before and after achieving a SVR in adult LT recipients treated for recurrent HCV infection with all-oral direct acting agents.

RESULTS:

We identified 52 liver LT treated recipients who achieved a SVR. The median (25th and 75th percentile interquartile range [IQR]) age was 62 years (57.75, 65). Most recipients received tacrolimus (TAC) for their immunosuppressant regimen. After achieving SVR, there was no statistically significant difference in daily dose of TAC unadjusted per weight (p > 0.05). However, there was a statistically significant decrease in daily dose of TAC adjusted per weight, serum levels of TAC, and the product of glomerular filtration rate and TAC. No statistically significant differences in cyclosporine unadjusted/adjusted per weight daily dose or serum levels were noted.

CONCLUSIONS:

Immunosuppression needs were increased for those patients treated with TAC but not cyclosporine. LT recipients prescribed TAC require close monitoring after treatment completion to avoid potential risk of acute rejection.

KEYWORDS:

Direct acting agents; Hepatitis C; Immunosuppressant; Liver transplantation

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