The Effect of Induction Therapy with Basiliximab on the Recurrence of Hepatitis C Virus in Living Donor Liver Transplantation (Retrospective Study)

Abstract

Hepatitis C virus (HCV) recurrence in HCV+ liver transplant recipients is almost inevitable and may be promoted by immunosuppression. Basiliximab, a high-affinity chimeric monoclonal antibody functions as an immunosuppressive agent, is effective in reducing acute rejection episodes in liver allograft recipients, but the influence on HCV recurrence might be a problem. Objectives: To study the effect of induction therapy with Basiliximab on HCV recurrence in adult living donor liver transplantation. Methods: This was a retrospective study to determine the effect of induction therapy with Basiliximab on the recurrence of HCV in the grafted liver. In this study 47 HCV patients were included who passed more than 6 month post-transplantation. All HCV recurrences were all proved histologically. All our patients received corticosteroids in addition to either tacrolimus (FK) or ciclosporine (Neoral), mycophenolate mofetil was given to all except 4 patients. Results: From the 47 transplanted patients 14 (29.8%) had HCV recurrence. In the group which used Basiliximab (Group I); the rate of HCV recurrence was 56.3%, while the group in which no Basilximab was used (Group II); the rate of HCV recurrence was 16.1% (P<0.001) highly significant. In patients who had HCV recurrence 64.3% of patients received induction therapy with Basiliximab, meanwhile in the non-recurrent group only 15.2% of patients received Basiliximab (P<0.001) highly significant. To out rule the role of either FK or Neoral in recurrence of HCV, we found that the rate of HCV recurrence was as follows: in a group of patients who received Basiliximab and FK; HCV recurrence occurred in 54.50%, in patients who did not receive Basiliximab but received FK; HCV recurrence occurred in 21.7% (P<0.001) highly significant. In patients who received Basiliximab and Neoral; HCV recurrence occurred in 60% and there was no HCV recurrence in patients who did not receive Basiliximab and received Neoral (P<0.001) highly significant. We also compared two groups of patients; those who received FK and Basiliximab (54.5%) had HCV recurrence, and in those who received Neoral and Basiliximab (60 %) had HCV recurrence (P > 0.05) non significant. Conclusion: The rate of HCV recurrence in LDLT is more when Basiliximab was used as induction therapy in patients undergoing LDLT for chronic HCV related end stage liver disease.