Minimization of immunosuppression with thymoglobuline pre-treatment and HCV recurrence in liver transplantation

:  Induction with thymoglobuline, a potent anti‐thymocyte polyclonal antibody, has been recently reported to allow minimization of postoperative immunosuppression in organ transplantation. The relationship with recurrence of hepatitis C virus (HCV) after liver transplantation (LTx) has never been in...

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Bibliographic Details
Published in:Clinical transplantation 2005-04, Vol.19 (2), p.255-258
Main Authors: Ruvo, Nicola De, Cucchetti, Alessandro, Lauro, Augusto, Masetti, Michele, Benedetto, Fabrizio Di, Cautero, Nicola, Barba, Giuliano La, Dazzi, Alessandro, Francesco, Fabrizio Di, Molteni, Gabriele, Romano, Antonio, Ramacciato, Giovanni, Risaliti, Andrea, Pinna, Antonio Daniele
Format: Article
Language:English
Subjects:
Adult
Aged
Antilymphocyte Serum - therapeutic use
Biological and medical sciences
Cardiology. Vascular system
DNA, Viral - analysis
Follow-Up Studies
Graft Rejection - etiology
Graft Survival
HCV
Hepacivirus - genetics
Hepatitis C - physiopathology
Hepatitis C - surgery
Humans
immunosuppression
Immunosuppression - methods
Immunosuppressive Agents - therapeutic use
Liver Transplantation
Medical sciences
Methylprednisolone - therapeutic use
Middle Aged
Nephrology. Urinary tract diseases
Recurrence
Survival Rate
T-Lymphocytes - immunology
Tacrolimus - therapeutic use
tolerance
Transplantation Conditioning
Treatment Outcome
Viral Load
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Summary::  Induction with thymoglobuline, a potent anti‐thymocyte polyclonal antibody, has been recently reported to allow minimization of postoperative immunosuppression in organ transplantation. The relationship with recurrence of hepatitis C virus (HCV) after liver transplantation (LTx) has never been investigated. We report here on the outcome in 22 HCV+ patients receiving thymoglobuline pre‐treatment and minimal immunosuppression after LTx. Patient survival and acute rejection rates were good, and remarkably low dosages and levels of immunosuppression were achieved with thymoglobuline, without exposing patients to an elevated risk of rejection. A progressive weaning of the primary immunosuppressor was also possible in the majority of patients without complications. The HCV recurrence rate was similar to what is reported in the literature, although lower HCV‐RNA viral loads were obtained with thymoglobuline, with a mild histologic course. Although our results need to be validated in large cohort studies, our experience shows that minimization of immunosuppression with thymoglobuline is effective in protecting against rejection and demonstrated a positive impact on HCV recurrence that deserves further investigation.
ISSN:0902-0063
1399-0012
DOI:10.1111/j.1399-0012.2005.00333.x