Long-term, maintenance MMF monotherapy improves the fibrosis progression in liver transplant recipients with recurrent hepatitis C

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.

MeSH terms

  • Aged
  • Antiviral Agents / pharmacology
  • Biopsy
  • Case-Control Studies
  • Cohort Studies
  • Disease Progression
  • Female
  • Fibrosis / drug therapy*
  • Fibrosis / pathology
  • Hepatitis C / therapy*
  • Humans
  • Immunosuppressive Agents / pharmacology*
  • Liver Failure / therapy*
  • Liver Transplantation / methods*
  • Male
  • Middle Aged
  • Mycophenolic Acid / analogs & derivatives*
  • Mycophenolic Acid / pharmacology
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome


  • Antiviral Agents
  • Immunosuppressive Agents
  • Mycophenolic Acid