Hepatitis C virus (HCV) infection of the graft is universal. Many factors has been studded in the recurrence of hepatitis as; Recipient age, BMI, HCV-RNA before transplantation, HCV-RNA after transplantation, Donor age, Graft Size, type of immunosuppression.
Our Immunosuppression Protocol: Tacrolimus, Cyclosporin micro emulsion, Mycophenolates, Corticosteroids which is tapered within first 3 months and Basiliximab as induction therapy in selected cases. Impact of tacrolimus versus Cyclosporin micro emulsion in hepatitis C virus-infected living related liver transplant recipients on recurrent hepatitis.
Liver Transplantation started five years ago in several centers in Egypt (more than 280 patients), In Wadi El Neel Hospital, Since October 2001; 107 patients underwent Living Donor Liver Transplantation 92 Adults and 15 Children. Mortality rate was: 32 patients (29.9%). Early Post Operative Mortality (27 patients) was 26.4%. Late Mortality (5 patients) was 4.7%.
This Study was started on 57 HCV Recipient; they were classified into two groups; Recurrent Group: 16 patients and Non Recurrent Group: 41 patients.
Recurrent Group: Mean Recipient age 48.56, Mean Recipient weight 78.44, Mean Donor Age 29.38, Mean HCV-RNA before transplantation 250.56 (X 10³), Mean HCV-RNA after transplantation 880.5 (X 10³), Mean Graft size 1.178 kg.
Immunosuppression: For Recurrent Group; 56.3% of patients were receiving Basiliximab as induction of immunosuppression and 43.8% didn’t. While Non Recurrent Group; only 9.8% receives and 90.2% didn’t, with P value: 0.0002 Very highly significant. The Correlation between Tacrolimus & Cyclosporin micro emulsion and
the recurrence of HCV.

	Number of		Number of
	Patients	%	Patients	%
Recurrent	12	%32	4	%20
Non Recurrent	25	68%	16	%80
*P value: 0.2469 Non Significant

The correlations were not significant between (patient's age, donor's age, donor's relation, graft size, HCV-RNA before transplantation, type of immunosuppressant) and occurrence of recurrence.
Significant correlations were detected between (HCV-RNA after transplantation, Basiliximab) and occurrence of recurrence. Tacrolimus is more associated with recurrence than Cyclosporin micro emulsion however this association is not significant may be due to small sample size. From This Study we recommend for patients with HCV genotype IV to start immunosuppression protocol as Cyclosporin micro emulsion, Mycophenolates and Basiliximab should be used as induction of immunosuppression in selected cases.