A new therapy to intractable rejection after liver transplantation / 中华器官移植杂志

ABSTRACT

Objective To explore a new therapeutic method to intractable rejection after liver transplantation.Methods Low dose prograft and rapamycin were given to 2 patients with intractable acute rejection and 2 patients with intractable chronic rejection confirmed by biopsy after liver transplantation, which had no response to normal treatment. The blood concentration of prograft was controlled in 3～5 ?g/L and rapamycin in 6～12 ?g/L. Rapamycin was withdrawn and prograft was increased to normal dose while the rejections were rectified.Results Four allograft rejections were all reversed in the end with this method. In the course of this therapy, one of the 4 patients had CMV pneumonia and cured with antiviral therapy. One had diabetes and another's diabetes got more critical. The blood glucose recovered to the primary level after the withdrawal of rapamycin.Conclusion The intractable acute and chronic rejection which has no response to normal treatment can be reversed by combined use of low dose prograft and rapamycin.