A controversy exists over whether the outcome of a hepatitis C virus-infection-related liver transplant differs based on the calcineurin inhibitor used.
Dr Marina Berenguer and colleagues from Spain performed a systematic review and a subsequent meta-analysis.
The research team evaluated tacrolimus-based vs cyclosporine A-based immunosuppression in Hepatitis C virus-infected liver transplant recipients.
The team conducted searches to locate randomized controlled trials comparing tacrolimus vs cyclosporine A.
|Mortality and graft survival did not differ between the therapies|
Data on Hepatitis C virus liver transplant recipients were obtained.
The team obtained the data irrespective of whether the study was specifically designed for patients with this disease or not.
The researchers used a fixed effects model for statistical pooling of the relative risks for the different outcomes.
The team found that a total of 5 articles involving 366 patients fulfilled the inclusion criteria.
The researchers did not find statistically significant differences between tacrolimus-based vs cyclosporine A-based therapies for mortality.
Graft survival, biopsy-proven acute rejection, corticoresistant acute rejection, and fibrosing cholestatic hepatitis also did not differ between the therapies.
In 1 study, the researchers detected no differences regarding severe fibrosis at 1 year.
Dr Berenguer's team concludes, “Patient and graft survivals in Hepatitis C virus-positive liver transplant patients are similar independently of the calcineurin inhibitor selected as basic immunosuppressant.”
“Unfortunately, data on the severity of recurrence and effect on viremia are scarce.”
“Well-designed randomized prospective studies are needed to determine whether there are differences between the 2 calcineurin inhibitors regarding these specific variables.”