Evidence map›Paper›PMID 25232255›Full record

ArticleWorld journal of gastroenterology2014

Impact of immunosuppression minimization and withdrawal in long-term hepatitis C virus liver transplant recipients.

Tommaso Maria Manzia, Roberta Angelico, Paolo Ciano, Jon Mugweru, Kofi Owusu, Daniele Sforza, Luca Toti, Giuseppe Tisone

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of gastroenterology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. World journal of gastroenterology · 2019
    Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Tommaso Maria ManziaTommaso Maria Manzia, Roberta Angelico, Paolo Ciano, Daniele Sforza, Luca Toti, Giuseppe Tisone, Department of Experimental Medicine and Surgery, Section of Transplantation, Tor Vergata University of Rome, 00133 Rome, Italy.
Roberta AngelicoTommaso Maria Manzia, Roberta Angelico, Paolo Ciano, Daniele Sforza, Luca Toti, Giuseppe Tisone, Department of Experimental Medicine and Surgery, Section of Transplantation, Tor Vergata University of Rome, 00133 Rome, Italy.
Paolo CianoTommaso Maria Manzia, Roberta Angelico, Paolo Ciano, Daniele Sforza, Luca Toti, Giuseppe Tisone, Department of Experimental Medicine and Surgery, Section of Transplantation, Tor Vergata University of Rome, 00133 Rome, Italy.
Jon MugweruTommaso Maria Manzia, Roberta Angelico, Paolo Ciano, Daniele Sforza, Luca Toti, Giuseppe Tisone, Department of Experimental Medicine and Surgery, Section of Transplantation, Tor Vergata University of Rome, 00133 Rome, Italy.
Kofi OwusuTommaso Maria Manzia, Roberta Angelico, Paolo Ciano, Daniele Sforza, Luca Toti, Giuseppe Tisone, Department of Experimental Medicine and Surgery, Section of Transplantation, Tor Vergata University of Rome, 00133 Rome, Italy.
Daniele SforzaTommaso Maria Manzia, Roberta Angelico, Paolo Ciano, Daniele Sforza, Luca Toti, Giuseppe Tisone, Department of Experimental Medicine and Surgery, Section of Transplantation, Tor Vergata University of Rome, 00133 Rome, Italy.
Luca TotiTommaso Maria Manzia, Roberta Angelico, Paolo Ciano, Daniele Sforza, Luca Toti, Giuseppe Tisone, Department of Experimental Medicine and Surgery, Section of Transplantation, Tor Vergata University of Rome, 00133 Rome, Italy.
Giuseppe TisoneTommaso Maria Manzia, Roberta Angelico, Paolo Ciano, Daniele Sforza, Luca Toti, Giuseppe Tisone, Department of Experimental Medicine and Surgery, Section of Transplantation, Tor Vergata University of Rome, 00133 Rome, Italy.
University of Rome Tor Vergata · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo investigate the effects of different immunosuppressive regimens and avoidance on fibrosis progression in hepatitis C virus (HCV) liver transplant (LT) recipients.

methodsWe retrospectively compared the liver biopsies of well-matched HCV LT recipients under calcineurin inhibitors (CNI group, n = 21) and mycophenolate (MMF group, n = 15) monotherapy, with those patients who successfully withdrawn immunosuppression (IS) therapy from at least 3 years (TOL group, n = 10). To perform the well-matched analysis, all HCV transplanted patients from December 1993 were screened. Only those HCV patients who reached the following criteria were considered for the analysis: (1) at least 3 years of post-operative follow-up; (2) patients with normal liver graft function under low dose CNI monotherapy (CNI group); (3) patients with normal liver graft function under antimetabolite (Micophenolate Mofetil or coated mycophenolate sodium) monotherapy (MMF group); and (4) recipients with normal liver function without any IS. We excluded from the analysis recipients who were IS free or under monotherapy for < 36 mo, recipients with cirrhosis or with unstable liver function tests.

resultsThirty six recipients were enrolled in the study. Demographics, clinical data, time after LT and baseline liver biopsies were comparable in the three groups. After six years of follow-up, there was no worsening of hepatic fibrosis in the MMF group (2.5 ± 1.5 Ishak Units vs 2.9 ± 1.7 Ishak Units, P = 0.5) and TOL group (2.7 ± 10.7 vs 2.5 ± 1.2, P = 0.2). In contrast, a significant increase in the fibrosis score was observed in the CNI group (2.2 ± 1.7 vs 3.9 ± 1.6, P = 0.008). The yearly fibrosis progression rate was significantly worse in the CNI group (0.32 ± 0.35) vs MMF group (0.03 ± 0.31, P = 0.03), and TOL group (-0.02 ± 0.27, P = 0.02). No differences have been reported in grading scores for CNI group (2.79 ± 1.9, P = 0.7), MMF group (3.2 ± 1.5, P = 0.9) and TOL group (3.1 ± 1.4, P = 0.2). Twenty four patients were treated with low dose ribavirin (8 TOL, 7 MMF, 9 CNI). The hepatitis C titers were comparable in the three groups. No episodes of rejection have been reported despite differences of liver function test in the three groups during the observational period.

conclusionIS withdrawal and MMF monotherapy is safe and seems to be associated with the slowest fibrosis progression in HCV LT recipients.

Indexed as

Liver TransplantationAdultAgedBiopsyCalcineurin InhibitorsDisease ProgressionDrug Administration ScheduleDrug Therapy, CombinationFemaleHepatitis CHumansImmunosuppressive AgentsLiver CirrhosisLiver Function TestsMaleMiddle AgedCalcineurin InhibitorsImmunosuppressive AgentsClinical operational toleranceHepatitis C virus recurrenceImmunosuppression withdrawalLiver transplantationMicofenolate mofetilMinimization of immunosuppression

Identifiers

PMID25232255
PMCPMC4161806
OpenAlexW2084754229

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.