UOC Transplant Unit, Department of Surgery, Tor Vergata University, Rome, Italy.
Transpl Int. 2011 May;24(5):461-8. doi: 10.1111/j.1432-2277.2011.01228.x. Epub 2011 Feb 5.
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.
丙型肝炎病毒（HCV）在肝移植（LT）后复发是普遍存在的。我们设计了一项回顾性病例对照研究，以评估霉酚酸酯（MMF）单药治疗在丙型肝炎复发患者中的效果。15 名经组织学证实 LT 后丙型肝炎复发的患者因肾功能损害和/或代谢副作用而从钙调神经磷酸酶抑制剂（CNIs）转换为 MMF 单药治疗，并接受了 48 个月的治疗（MMF 组）。15 名匹配良好的 LT 受者在同一时期继续接受 CNI 治疗作为对照组。两组的人口统计学、临床数据、LT 后时间和基线肝活检相似。在 MMF 组，研究期间肝纤维化没有恶化[2.6 ± 1.5（基线）Ishak 单位与 2.7 ± 1.8（MMF 治疗 48 个月后），P = 0.6]。相比之下，在对照组中观察到纤维化评分显著增加[2 ± 1.1（基线）与 3.2 ± 1.7（CNI 治疗 48 个月后），P = 0.0002]。MMF 组的每年纤维化进展率为 0.05 ± 0.44，CNI 组为 0.33 ± 0.24（P = 0.04）。MMF 单药治疗与 HCV 肝移植受者肝纤维化进展的有利影响相关。
