Routine induction therapy in living donor liver transplantation prevents rejection but may promote recurrence of hepatitis C.
Transplant Proc
; 44(5): 1351-6, 2012 Jun.
Article
em En
| MEDLINE
| ID: mdl-22664014
ABSTRACT
BACKGROUND:
Routine induction therapy in living donor liver transplantation (LDLT) has not been well described.METHODS:
We reviewed outcomes of induction therapy with rabbit antithymocyte globulin (rATG) or basiliximab within 1 year of LDLT.RESULTS:
Between 2002 and 2007, 184 adults underwent LDLT and received induction therapy in addition to standard immunosuppression. Acute cellular rejection (ACR) developed in 17 of 130 patients (13.1%) who received rATG and 13 of 54 patients (24.1%) who received basiliximab (P = .066). The interval between transplantation and rejection as well as rejection severity was similar in patients who received rATG and those who received basiliximab. Hepatitis C (HCV) recurrence requiring initiation of antiviral therapy was more common in patients who received rATG compared with basiliximab (34.5% vs 8.7%; P = .021), and in those who received induction combined with tacrolimus as opposed to cyclosporine (38.5% vs 3.9%; P = .001). rATG and basiliximab were associated with excellent patient and graft survivals well as low rates of opportunistic infections and malignancies.CONCLUSION:
Induction with rATG or basiliximab was well tolerated and highly effective at preventing ACR within 1 year of LDLT, but may be associated with a higher risk of clinically significant HCV recurrence in some patients.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Proteínas Recombinantes de Fusão
/
Transplante de Fígado
/
Hepatite C
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Condicionamento Pré-Transplante
/
Doadores Vivos
/
Rejeição de Enxerto
/
Imunossupressores
/
Cirrose Hepática
/
Anticorpos Monoclonais
/
Soro Antilinfocitário
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Transplant Proc
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Canadá