A Prospective Randomized Trial of Tacrolimus and Prednisone Versus Tacrolimus, Prednisone and Mycophenolate Mofetil in Primary Adult Liver Transplantation: A Single Center Report1

Jain, Ashokkumar; Kashyap, Randeep; Dodson, Forrest; Kramer, David J.; Hamad, Imad; Khan, Rafeeq Alam; Eghestad, B.; Starzl, Thomas E.; Fung, John J.

doi:10.1097/00007890-200109270-00019

Cited by 43 publications

(27 citation statements)

References 22 publications

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“…The 12% ACR rate of our study compares favorably with the 38% 1-year rejection rate recently reported by Boillot et al (12) as well as the 45.2% 1-year rejection rate reported by Jain et al (13) from the Pittsburgh group. The difference is even more dramatic when our results are compared to the U.S. and European multicenter FK506 liver study groups, in which the 1-year rejection rates with steroids and tacrolimus were 68%, and 40.5%, respectively (14,15).…”

Section: Discussionsupporting

confidence: 88%

Efficacy and Safety of Basiliximab with a Tacrolimus-Based Regimen in Liver Transplant Recipients

et al. 2004

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Background. Induction with monoclonal antibodies for prevention of acute cellular rejection (ACR) may avoid many of the adverse events associated with polyclonal antibodies. Basiliximab, a chimeric monoclonal antibody directed against the ␣-chain of the interleukin 2 receptor (CD25), has been extensively evaluated as an induction therapy for kidney transplant recipients, more frequently in combination with a cyclosporine-based regimen. In this study, we assessed the efficacy and safety of basiliximab in combination with a tacrolimus-based regimen after liver transplantation. Methods. Fifty consecutive liver transplants (47 cadaveric donors; 3 living donors) were analyzed. All patients received two 20-mg doses of basiliximab (days 0 and 4 after transplantation) followed by tacrolimus (0.15 mg/kg/day; 10 -15 ng/mL target trough levels) and a tapered dose regimen of steroids. Follow-up ranged from 404 to 1,364 days after transplantation (mean 799.89 days, SDϮ257.37; median 796 days). Results. A total of 88% of patients remained rejection-free during follow-up with an actuarial rejection-free probability of 75% within 3 months. The actuarial patient survival rate at 3 years was 88%, and the graft survival rate was 75%. Twelve (24%) patients experienced one episode of sepsis, requiring temporary reduction of immunosuppressive therapy. There were no immediate side effects associated with basiliximab and no evidence of cytomegalovirus infection or posttransplant lymphoproliferative disorder. Conclusions. Basiliximab in combination with a tacrolimus-based immunosuppressive regimen is effective in reducing episodes of ACR and increasing ACR-free survival after liver transplantation. In addition, basiliximab does not increase the incidence of adverse effects or infections.

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Section: Discussionsupporting

confidence: 88%

Efficacy and Safety of Basiliximab with a Tacrolimus-Based Regimen in Liver Transplant Recipients

et al. 2004

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“…The rate of discontinuations because of adverse events declines after the first few months posttransplant (15,16), with varying reports of between 2% and 13% of patients discontinuing MPA therapy because of intolerance during years 1 to 3 posttransplant (17,18). Our results extend previous findings that graft survival is adversely affected by MMF dose reduction or discontinuation during the first year after kidney transplantation (13)(14)(15)19), and highlight the need to maintain adequate MPA dosing long-term.…”

supporting

confidence: 81%

Effect on Kidney Graft Survival of Reducing or Discontinuing Maintenance Immunosuppression After the First Year Posttransplant

Opelz

Döhler

2008

Transplantation

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“…[16][17][18][19][20] The aim of the present study is to examine the impact of MMF therapy in HCV-positive liver transplant recipients administered tacrolimus (TAC)-based immunosuppression. 21,22 One hundred six patients on this trial underwent LT for end-stage liver disease secondary to HCV infection. The diagnosis of HCV was made on the basis of qualitative analysis of reverse-transcriptase polymerase chain reaction.…”

mentioning

confidence: 99%

A prospective randomized trial of mycophenolate mofetil in liver transplant recipients with hepatitis C

Jain

2002

Liver Transplantation

129

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Hepatitis C is the most common indication for liver transplantation (LT) in the United States. Recurrence of hepatitis C virus (HCV) infection post-LT remains a problem for which there is no completely satisfactory treatment. The aim of the present study is to evaluate mycophenolate mofetil (MMF), which has both immunosuppressive and antiviral properties, to determine whether it is associated with a difference in the rate of HCV recurrence and also examine its impact on patient and graft survival. Between August 1995 and May 1998, a total of 106 patients who were HCV positive before LT were randomized to tacrolimus (

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A Prospective Randomized Trial of Tacrolimus and Prednisone Versus Tacrolimus, Prednisone and Mycophenolate Mofetil in Primary Adult Liver Transplantation: A Single Center Report1

Cited by 43 publications

References 22 publications

Efficacy and Safety of Basiliximab with a Tacrolimus-Based Regimen in Liver Transplant Recipients

Efficacy and Safety of Basiliximab with a Tacrolimus-Based Regimen in Liver Transplant Recipients

Effect on Kidney Graft Survival of Reducing or Discontinuing Maintenance Immunosuppression After the First Year Posttransplant

A prospective randomized trial of mycophenolate mofetil in liver transplant recipients with hepatitis C

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