Audiometric changes in patients undergoing liver transplantation using distinct immunosuppressive protocols

Area of Science:

• Nephrology
• Immunology
• Otolaryngology

Background:

• Liver transplantation (LT) is a life-saving procedure.
• Immunosuppressive drugs like cyclosporine (CyA) and tacrolimus (FK-506) are crucial post-transplant.
• Potential side effects of these drugs require ongoing investigation.

Purpose of the Study:

• To investigate the association between hearing defects and the use of CyA versus FK-506 in liver transplant recipients.
• To determine if immunosuppressive regimens impact auditory function post-LT.

Main Methods:

• Pure-tone audiometry (PTA) was conducted on 42 LT patients before and after transplantation.
• Patients were stratified into two groups: CyA users (n=18) and FK-506 users (n=24).
• Statistical analyses included Kolmogorov-Smirnov, Student t test, Wilcoxon signed-rank, and Mann-Whitney tests (P

Main Results:

• A statistically significant decrease in hearing perception, especially at high frequencies (4000, 6000, 8000 Hz), was observed in both ears of patients receiving FK-506.
• Audiometric changes were not significant pre- and post-LT in CyA users, except for a minor change at 3000 Hz in the right ear.
• Worsening of hearing patterns was evident in LT patients, more pronounced in the high-frequency range for FK-506 users.

Conclusions:

• Liver transplant recipients exhibit a decline in hearing function post-transplantation.
• The immunosuppressive drug tacrolimus (FK-506) is associated with a more significant high-frequency hearing defect compared to cyclosporine (CyA).
• Further research is warranted to elucidate the mechanisms behind FK-506-induced ototoxicity.