Long-term, maintenance MMF monotherapy improves the fibrosis progression in liver transplant recipients with recurrent hepatitis C

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http://onlinelibrary.wiley.com/doi/10.1111/j.1432-2277.2011.01228.x/abstract

Long-term, maintenance MMF monotherapy improves the fibrosis progression in

liver transplant recipients with recurrent hepatitis C

Tommaso Manzia1, a Angelico1, Luca Toti1, Irene Bellini1,

e Sforza1, Giampiero Palmieri2, Giuseppe Orlando3, Tariciotti1,

Angelico4, Giuseppe Tisone1Article first published online: 5 FEB 2011

DOI: 10.1111/j.1432-2277.2011.01228.x

© 2011 The Authors. Transplant International © 2011 European Society for Organ

Transplantation

Issue

Transplant International

Volume 24, Issue 5, pages 461–468, May 2011

Summary

Hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (LT)

is universal. We designed a retrospective case–control study to evaluate the

effect of mycophenolate mofetil (MMF) monotherapy in patients with recurrent

hepatitis C. Fifteen patients with histologically proven hepatitis C recurrence

after LT were switched from calcineurin inhibitors (CNIs) to MMF monotherapy

because of impairment of kidney function and/or metabolic side effects, and

treated for 48 months (MMF group). Fifteen well-matched LT recipients who

continued to receive CNIs therapy over the same period served as control group.

Demographics, clinical data, time after LT, and baseline liver biopsies were

similar in the two groups. There was no worsening of hepatic fibrosis during the

study in the MMF group [2.6 ± 1.5 (baseline) Ishak Units vs. 2.7 ± 1.8 (after 48

months of MMF treatment), P = 0.6]. In contrast, a significant increase in the

fibrosis score [2 ± 1.1 (baseline) vs. 3.2 ± 1.7 (after 48 months of CNI

treatment), P = 0.0002] was observed in the control group. The yearly fibrosis

progression rate was of 0.05 ± 0.44 in the MMF group and 0.33 ± 0.24 in the CNI

group (P = 0.04). MMF monotherapy is associated with a favourable effect on

hepatic fibrosis progression in HCV liver transplant recipients.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1432-2277.2011.01228.x/abstract

Long-term, maintenance MMF monotherapy improves the fibrosis progression in

liver transplant recipients with recurrent hepatitis C

Tommaso Manzia1, a Angelico1, Luca Toti1, Irene Bellini1,

e Sforza1, Giampiero Palmieri2, Giuseppe Orlando3, Tariciotti1,

Angelico4, Giuseppe Tisone1Article first published online: 5 FEB 2011

DOI: 10.1111/j.1432-2277.2011.01228.x

© 2011 The Authors. Transplant International © 2011 European Society for Organ

Transplantation

Issue

Transplant International

Volume 24, Issue 5, pages 461–468, May 2011

Summary

Hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (LT)

is universal. We designed a retrospective case–control study to evaluate the

effect of mycophenolate mofetil (MMF) monotherapy in patients with recurrent

hepatitis C. Fifteen patients with histologically proven hepatitis C recurrence

after LT were switched from calcineurin inhibitors (CNIs) to MMF monotherapy

because of impairment of kidney function and/or metabolic side effects, and

treated for 48 months (MMF group). Fifteen well-matched LT recipients who

continued to receive CNIs therapy over the same period served as control group.

Demographics, clinical data, time after LT, and baseline liver biopsies were

similar in the two groups. There was no worsening of hepatic fibrosis during the

study in the MMF group [2.6 ± 1.5 (baseline) Ishak Units vs. 2.7 ± 1.8 (after 48

months of MMF treatment), P = 0.6]. In contrast, a significant increase in the

fibrosis score [2 ± 1.1 (baseline) vs. 3.2 ± 1.7 (after 48 months of CNI

treatment), P = 0.0002] was observed in the control group. The yearly fibrosis

progression rate was of 0.05 ± 0.44 in the MMF group and 0.33 ± 0.24 in the CNI

group (P = 0.04). MMF monotherapy is associated with a favourable effect on

hepatic fibrosis progression in HCV liver transplant recipients.