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Saidi RF, Hertl M, Chung RT, et al. Induction with Rabbit Antithymocyte Globulin following Orthotopic Liver Transplantation for Hepatitis C. Int J Organ Transplant Med. 2011;2(4):160-5
Saidi, R. F., Hertl, M., Chung, R. T., Ko, D. S., Kawai, T., Markmann, J., Bhan, A. K., Cosimi, A. B., & Elias, N. (2011). Induction with Rabbit Antithymocyte Globulin following Orthotopic Liver Transplantation for Hepatitis C. International journal of organ transplantation medicine, 2(4), 160-5.
Saidi, R F, et al. "Induction with Rabbit Antithymocyte Globulin following Orthotopic Liver Transplantation for Hepatitis C." International journal of organ transplantation medicine vol. 2,4 (2011): 160-5.
Saidi RF, Hertl M, Chung RT, Ko DS, Kawai T, Markmann J, Bhan AK, Cosimi AB, Elias N. Induction with Rabbit Antithymocyte Globulin following Orthotopic Liver Transplantation for Hepatitis C. Int J Organ Transplant Med. 2011;2(4):160-5. PMID: 25013609; PMCID: PMC4089267.
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Int J Organ Transplant Med. 2011;2(4):160-5.

Induction with Rabbit Antithymocyte Globulin following Orthotopic Liver Transplantation for Hepatitis C.

International journal of organ transplantation medicine

R F Saidi, M Hertl, R T Chung, D S C Ko, T Kawai, J Markmann, A K Bhan, A B Cosimi, N Elias

Affiliations

  1. Department of Surgery-Transplantation Unit.
  2. Gastrointestinal Unit, Department of Medicine.
  3. Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

PMID: 25013609 PMCID: PMC4089267

Abstract

BACKGROUND: Hepatitis C (HCV) is the most common indication for liver transplantation in the US.

OBJECTIVE: Since steroids are the major stimulus of viral replication, we postulated that steroid-free immunosuppression might be a safer approach.

METHODS: From January 1995 to October 2002, we used steroid plus calcineurin inhibitor (CNI) immunosuppression after liver transplantation for HCV (steroid group, n=81). From October 2002 to June 2007, rabbit antithymocyte globulin (RATG) induction, followed by CNI and azathioprine (RATG group, n=73) was utilized.

RESULTS: There were no differences in 1- and 3-year patient/allograft survival rates. The incidence of acute rejection rate (19% vs. 28%), of biopsy-proven HCV recurrence (70% vs. 75%), and chronic rejection (6% vs. 9%) were comparable. The mean time to develop recurrent HCV was significantly longer in the RATG group (16.2 vs. 9.2 months, p=0.008). The incidence of severe portal fibrosis appears to be lower in RATG group compared to the steroid group; 14% vs. 4% (p=0.07).

CONCLUSIONS: RATG induction is safe and effective after liver transplantation for HCV, but has no impact on the incidence of HCV recurrence and patient/allograft survival. However, a significant delay in time to HCV recurrence and a trend toward less rejection and portal fibrosis was observed.

Keywords: Hepatitis C; Induction; Liver transplantation; Recurrence

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