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Background. Hepatitis C virus (HCV) recurrence in HCV+liver transplant recipients is almost inevitable and may be promoted by immunosuppression. We compared the amount of liver damage with regard to usage of steroids and basiliximab. Methods. A total of 140 HCV+ adult liver transplant recipients were randomly allocated to basiliximab+steroids or basiliximab+placebo (plus cyclosporine and azathioprine). Primary endpoint: hepatitis C histological recurrence (liver damage as for Ishak grading score ≥8 by biopsy at 12 months); secondary endpoints: treatment failure (death, graft loss, patient withdrawal), biopsy proven acute rejection (BPAR), treated acute rejection (tAR), allograft and patient survival rates at 12 months. Results. Any significant difference has been observed in the 12-month hepatitis C histological recurrence rate (41.2% basiliximab+steroids, 37.5% basiliximab+placebo, P=0.354). The treatment failure rate was significantly higher in basiliximab+steroids (28.8%) than in basiliximab+placebo (15.6%), P=0.03; the combination test for the evaluation of the joint hypothesis resulted in a borderline nonsignificant overall result (P=0.059). BPAR rate was significantly lower in the group treated with steroids (24.3% basiliximab+steroids, 39.4% basiliximab+placebo, P=0.04), while the tAR rate was similar (29.7% basiliximab+steroids and 37.9% basiliximab+placebo). Any significant differences in 1-year graft and patient survival rates have been observed (72.9% and 84.8% basiliximab+steroids; 81.5% and 89.0% basiliximab+placebo). Conclusions. Results suggest that steroid-free therapy is associated with a significantly lower treatment failure rate, although histological recurrence rate of hepatitis C is similar in the two groups. This benefit is not offset by an evident increase in graft rejection rate requiring treatment

One of the major technical obstacles to liver transplantation in children is to find a liver of appropriate size because of the rarity of child donors. To overcome this difficulty an experimental study was carried out using only a portion of the donor liver (right liver) transplanted orthotopically in pigs. A group of 15 allo-transplants were performed. A left hepatectomy of the liver graft was performed ex situ and the right liver amounted to 55% of the whole liver. A total of 13 animals survived for more than 5 days (5 to 30 days, with an average of 16). Upon killing, the liver weight was considerably more than that of the part transplanted. The absence of technical complications suggests that this procedure is safe and feasible. © 1987 by The Williams and Wilkins Co