Cyclosporin A, but not tacrolimus, negatively affects the hepatic extraction fraction of hepatobiliary scintigraphy in liver transplant recipients.

Anastasios Kaxiras,Bo-Göran Ericzon,Annika Wernerson,Gunnar Söderdahl,Rimma Axelsson,Shinji Yamamoto

doi:10.1186/s13550-014-0073-z

Anastasios Kaxiras, Bo-Göran Ericzon + Show 4 more

Open Access

https://doi.org/10.1186/s13550-014-0073-z

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Abstract

BackgroundHepatobiliary scintigraphy using 99mTc-mebrofenin has been used as an investigation to study liver function after liver transplantation (LTx). Hepatic extraction fraction (HEF) is a measurement of the hepatic extraction efficiency and hepatic extraction rate. With the purpose of evaluating a possible diverging effect of cyclosporin A (CSA) and tacrolimus (TAC) on the HEF, we compared the HEF with biochemical and histological parameters in LTx patients receiving either CSA or TAC.MethodsThirty-nine adult patients who underwent LTx due to hepatitis C virus (HCV) cirrhosis were evaluated. All patients underwent a 3-month and 1-year follow-up that included hepatobiliary scintigraphy and biochemistry tests. Liver biopsy was performed at 1 year. These clinical parameters were compared between the two groups, TAC (n = 15) and CSA (n = 24).ResultsThe average HEF was significantly lower in the CSA group compared to the TAC group both at 3 months and 1 year after LTx. The liver biochemistry tests, average donor and recipient age, average cold ischemia time (CIT), and a clearance were comparable in the two groups. The TAC group had more inflammation than the CSA group. Moreover, three patients who converted from CSA to TAC increased their HEF values.ConclusionsCSA-treated patients presented a lower HEF value on hepatobiliary scintigraphy in spite of comparable liver function by traditional measurements indicating a decrease on HEF values by CSA.

Highlights

Hepatobiliary scintigraphy using 99mTc-mebrofenin has been used as an investigation to study liver function after liver transplantation (LTx)
We have previously reported a significant correlation between early post-LTx Hepatic extraction fraction (HEF) values and biochemical parameters [14]
There was no statistical difference of recipient, donor and graft parameters, and post-operative complication between the cyclosporin A (CSA) group and the TAC group

Summary

Introduction

Hepatobiliary scintigraphy using 99mTc-mebrofenin has been used as an investigation to study liver function after liver transplantation (LTx). Recurrence of HCV infection can occur as early as 4 weeks after liver transplantation [4]; this may a noninvasive method and allows for detection of postoperative structural complications such as biliary obstructions/dilatations and biliary leakage. It can provide information concerning functional components of the liver graft, such as the rate of uptake, perfusion, and excretion of a tracer [9]. One important parameter of biliary scintigraphy that is of great value in the evaluation of transplanted liver grafts is the hepatic extraction fraction (HEF) [14]. We have previously reported a significant correlation between early post-LTx HEF values and biochemical parameters [14]

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