This study compares the clinical course of recurrent hepatitis C virus (HCV) infection between 64 patients, who were randomized to receive either rabbit antithymocyte globulin (RATG) or steroids as induction therapy with tacrolimus for maintenance. The HCV recurrence was assessed by HCV RNA levels, peak ALT at 3-6 months, the grade of inflammation at biopsy at 3-6 months posttransplant, progression of fibrosis, and survival. All patients had also received antiviral therapy with interferon alpha 2b and ribavirin, if there were no contraindications. There was no statistically significant difference between the two groups in terms of inflammation at 3 months, peak ALT, or HCV RNA. The survival between the two groups of patients was similar. It appears that steroid-free liver transplantation with RATG induction does not have any negative influence on HCV recurrence in hepatitis C patients after liver transplantation.