Results of a Two-Center Study Comparing Hepatic Fibrosis Progression in HCV-positive Liver Transplant Patients Receiving Cyclosporine or Tacrolimus

A 2-center retrospective analysis was performed in 60 patients undergoing liver transplantation for hepatitis C virus (HCV)-related disease (cyclosporine in 20, tacrolimus in 40). Mean (+/- SEM) follow-up was 23.6 +/- 22.5 and 22.3 +/- 13.7 months in patients receiving cyclosporine or tacrolimus, respectively. Clinically indicated biopsies were performed in 15/20 cyclosporine patients (75%) and 22/40 tacrolimus patients (55%; P = .17). The Ishak fibrosis score was significantly lower in cyclosporine-treated patients versus tacrolimus-treated patients (mean 1.7 +/- 0.4 vs 3.1 +/- 0.4; P = .023), as was percentage of fibrosis grade Ishak >= 4 (7% vs 41%; P = .028). The mean time to moderate fibrosis (Ishak score >= 3) was 38.2 +/- 15.1 months in cyclosporine patients (4/15) and 23.5 +/- 12.6 months in tacrolimus patients (14/22); the difference was not statistically significant (P = .09). This retrospective study suggests that cyclosporine-based immunosuppression is associated with less severe hepatic fibrosis in HCV-positive liver transplant recipients compared with tacrolimus-based regimens, but a larger prospective comparative trial is necessary to confirm these findings.