Tacrolimus-based versus cyclosporine-based immunosuppression in hepatitis C virus-infected patients after liver transplantation: a meta-analysis and systematic review.
<h4>Background</h4>Most liver transplant recipients receive calcineurin inhibitors (CNIs), especially tacrolimus and cyclosporine, as immunosuppressant agents to prevent rejection. A controversy exists as to whether the outcomes of hepatitis C virus (HCV)-infected liver transplant patien...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0107057 |
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| author | Zhenmin Liu Yi Chen Renchuan Tao Jing Xv Jianyuan Meng Xiangzhi Yong |
| author_facet | Zhenmin Liu Yi Chen Renchuan Tao Jing Xv Jianyuan Meng Xiangzhi Yong |
| author_sort | Zhenmin Liu |
| collection | DOAJ |
| description | <h4>Background</h4>Most liver transplant recipients receive calcineurin inhibitors (CNIs), especially tacrolimus and cyclosporine, as immunosuppressant agents to prevent rejection. A controversy exists as to whether the outcomes of hepatitis C virus (HCV)-infected liver transplant patients differ based on the CNIs used. This meta-analysis compares the clinical outcomes of tacrolimus-based and cyclosporine-based immunosuppression, especially cases of HCV recurrence in liver transplant patients with end-stage liver disease caused by HCV infection.<h4>Methods</h4>Related articles were identified from the Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, Medline, and Embase. Meta-analyses were performed for the results of homogeneous studies.<h4>Results</h4>Nine randomized or quasi-randomized controlled trials were included. The total effect size of mortality (RR = 0.98, 95% CI: 0.77-1.25, P = 0.87) and graft loss (RR = 1.05, 95% CI: 0.83-1.33, P = 0.67) showed no significant difference between the two groups irrespective of duration of immunosuppressant therapy after liver transplantation. In addition, the HCV recurrence-induced mortality (RR = 1.11, 95% CI: 0.66-1.89, P = 0.69), graft loss (RR = 1.62, 95% CI: 0.64-4.07, P = 0.31) and retransplantation (RR = 1.40, 95% CI: 0.48-4.09, P = 0.54), as well as available biopsies, confirmed that histological HCV recurrences (RR = 0.92, 95% CI: 0.71-1.19, P = 0.51) were similar.<h4>Conclusion</h4>These results suggested no difference in posttransplant HCV recurrence-induced mortality, graft loss and retransplantation, as well as histological HCV recurrence in patients treated with tacrolimus-based and cyclosporine-based immunosuppresion. |
| format | Article |
| id | doaj-art-73dc7f5020b044b8ae3ae2b0afa29d13 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-73dc7f5020b044b8ae3ae2b0afa29d132025-08-20T03:56:05ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0199e10705710.1371/journal.pone.0107057Tacrolimus-based versus cyclosporine-based immunosuppression in hepatitis C virus-infected patients after liver transplantation: a meta-analysis and systematic review.Zhenmin LiuYi ChenRenchuan TaoJing XvJianyuan MengXiangzhi Yong<h4>Background</h4>Most liver transplant recipients receive calcineurin inhibitors (CNIs), especially tacrolimus and cyclosporine, as immunosuppressant agents to prevent rejection. A controversy exists as to whether the outcomes of hepatitis C virus (HCV)-infected liver transplant patients differ based on the CNIs used. This meta-analysis compares the clinical outcomes of tacrolimus-based and cyclosporine-based immunosuppression, especially cases of HCV recurrence in liver transplant patients with end-stage liver disease caused by HCV infection.<h4>Methods</h4>Related articles were identified from the Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, Medline, and Embase. Meta-analyses were performed for the results of homogeneous studies.<h4>Results</h4>Nine randomized or quasi-randomized controlled trials were included. The total effect size of mortality (RR = 0.98, 95% CI: 0.77-1.25, P = 0.87) and graft loss (RR = 1.05, 95% CI: 0.83-1.33, P = 0.67) showed no significant difference between the two groups irrespective of duration of immunosuppressant therapy after liver transplantation. In addition, the HCV recurrence-induced mortality (RR = 1.11, 95% CI: 0.66-1.89, P = 0.69), graft loss (RR = 1.62, 95% CI: 0.64-4.07, P = 0.31) and retransplantation (RR = 1.40, 95% CI: 0.48-4.09, P = 0.54), as well as available biopsies, confirmed that histological HCV recurrences (RR = 0.92, 95% CI: 0.71-1.19, P = 0.51) were similar.<h4>Conclusion</h4>These results suggested no difference in posttransplant HCV recurrence-induced mortality, graft loss and retransplantation, as well as histological HCV recurrence in patients treated with tacrolimus-based and cyclosporine-based immunosuppresion.https://doi.org/10.1371/journal.pone.0107057 |
| spellingShingle | Zhenmin Liu Yi Chen Renchuan Tao Jing Xv Jianyuan Meng Xiangzhi Yong Tacrolimus-based versus cyclosporine-based immunosuppression in hepatitis C virus-infected patients after liver transplantation: a meta-analysis and systematic review. PLoS ONE |
| title | Tacrolimus-based versus cyclosporine-based immunosuppression in hepatitis C virus-infected patients after liver transplantation: a meta-analysis and systematic review. |
| title_full | Tacrolimus-based versus cyclosporine-based immunosuppression in hepatitis C virus-infected patients after liver transplantation: a meta-analysis and systematic review. |
| title_fullStr | Tacrolimus-based versus cyclosporine-based immunosuppression in hepatitis C virus-infected patients after liver transplantation: a meta-analysis and systematic review. |
| title_full_unstemmed | Tacrolimus-based versus cyclosporine-based immunosuppression in hepatitis C virus-infected patients after liver transplantation: a meta-analysis and systematic review. |
| title_short | Tacrolimus-based versus cyclosporine-based immunosuppression in hepatitis C virus-infected patients after liver transplantation: a meta-analysis and systematic review. |
| title_sort | tacrolimus based versus cyclosporine based immunosuppression in hepatitis c virus infected patients after liver transplantation a meta analysis and systematic review |
| url | https://doi.org/10.1371/journal.pone.0107057 |
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