Education and Training
Sustained Virological Response (SVR) to Antiviral Treatment of Liver Transplant Recipients With Recurrent Hepatitis C
This study will assess the rates of Sustained Virological Response following anti-viral therapy with Peg-Interferon plus Ribavirin in patients that have been liver transplanted with recurrent Hepatitis C and treated with Neoral or tacrolimus.
Stanford is currently not accepting patients for this trial.
Stanford Investigator(s):
Intervention(s):
- drug: cyclosporin (Neoral)
- drug: tacrolimus (Prograf)
Eligibility
Inclusion criteria:
- Liver transplantation performed at least 6 months and up to 5 years prior
randomization and due to HCV cirrhosis, with or without pre-transplant hepatocellular
carcinoma (HCC) within Milan or UCSF criteria
- Immunosuppresive regimen based on tacrolimus b.i.d.- (twice or once daily) for at
least 6 months prior randomization
- Diagnosis of HCV genotypes 1 or 4 infection prior to transplantationconfirmed at
screening
- Indication of treatment with Peg-IFN and ribavirin due to histological evidence of
chronic HCV infection defined as a fibrosis stage equal or greater than 1 using the
Ishak-Knodell scoring system (IK ≥1) in a liver biopsy performed at screening or up to
4 months prior to randomization.
Exclusion criteria:
- Serum creatinine >150 μmol/L (1.6 7 mg/dL) or eGFR < 50 ml/min (4-variable
Modification of Diet in Renal Disease [MDRD Cockcroft-Gault formula])
- Multi-organ transplant recipients
- Recent episode of steroid-treated acute rejection (AR) within 3 months prior to
randomization, or >1 episode of steroid-treated AR in the last 6 months, or any number
of steroid-resistant AR episodes in the last 6 months including evidence of chronic
rejection or ductopenia
- Evidence of conditions that could cause graft dysfunction other than HCV infection
- Patients with signs of decompensated liver disease, defined as presence of ascites,
variceal bleeding, encephalopathy or deteriorated hepatic synthetic function (albumin
<3.5g/dL or, total direct bilirubin >1.5mg/dL or, INR >1.5)
- Co-infection with HIV or Hepatitis B (defined as HBsAg-positive) at screening
- Use of mTOR inhibitors (everolimus or sirolimus) in the 6 months prior to screening
- Antiviral treatment for HCV administered at any time after liver transplantation
- Patients on daily doses of corticosteroids higher than 5 mg/day
- Patients with fibrosing cholestatic hepatitis
- Patients with current diagnosis of malignancies, including lymphoproliferative
disorders
- Patients with platelet count <70,000/mm3 or neutrophiles <1,500/mm3
- History of HCC outside Milan criteria based on radiology or UCSF criteria based on
analysis of the explant
Ages Eligible for Study
18 Years - 70 Years
Genders Eligible for Study
All
Not currently accepting new patients for this trial
Contact Information
Stanford University
School of Medicine
300 Pasteur Drive
Stanford,
CA
94305
Mindie Nguyen, MD
650-498-7878
Not Recruiting