A Safe Immunosuppressive Protocol in Adult-to-Adult Living Related Liver Transplantation

Gruttadauria, Salvatore; Cintorino, Davide; Piazza, Tommaso; Mandalà, Lucio; Doffria, E; Musumeci, Antonino; Trapani, Gabriela; Scianna, Giovanni; Spada, Marco; Verzaro, Roberto; Volpes, Riccardo; Vizzini, Giovanni; Palazzo, U; Minervini, Marta Ida; Marsh, J.W.; Marcos, Amadeo; Gridelli, Bruno

doi:10.1016/j.transproceed.2006.02.141

Cited by 12 publications

(8 citation statements)

References 12 publications

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“…While there was no significant difference in rejection episodes at 6 and 12 months between the two groups, the HCV-negative group treated with basiliximab did experience a statistically significant reduction in acute rejection at 6 months (P = 0.03). Several retrospective reviews have demonstrated significant differences in ACR with basiliximab [13][14][15] or daclizumab [16] induction in addition to standard CNI-based regimens. Ramirez and colleagues performed the largest series in this group, examining 46 patients after OLT receiving basiliximab induction in the setting of a tacrolimus and steroid-based regimen, with or without MMF, compared with 46 historic controls receiving dual or triple standard immunosuppression.…”

Section: Induction As An Adjunct To Conventional Immunosuppressionmentioning

confidence: 99%

“…The international use of induction immunosuppression in liver transplantation is similar to that which has been presented previously, namely to facilitate steroid avoidance or calcineurin inhibitor minimization. Several of the trials presented here are from centers in Europe [8,12,13,47,49,52,54,[61][62][63][64] and Asia [11,14,65]. One such CNI minimizing strategy is termed the 'bottom up' approach to patients with pretransplant renal insufficiency at a European center.…”

Section: International Practicesmentioning

confidence: 99%

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Induction immunosuppression in liver transplantation: a review

Turner

Knechtle

2013

Transpl Int

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Summary Antibody therapy for induction is seldom used in liver transplantation in the United States, but continues to be used in approximately 10% of patients. The most commonly used antibody at the current time is basiliximab (Simulect, Novartis) and is used in adults with renal dysfunction at the time of liver transplantation with the intention of delaying introduction of calcineurin‐inhibitors. In children, the same antibody is commonly used in order to reduce rates of acute rejection. Most patients, adult and pediatric, are treated with initially higher levels of tacrolimus rather than antibody induction.

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Section: Induction As An Adjunct To Conventional Immunosuppressionmentioning

confidence: 99%

Section: International Practicesmentioning

confidence: 99%

Induction immunosuppression in liver transplantation: a review

Turner

Knechtle

2013

Transpl Int

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“…Therefore, safety is the premise of a steroid-free IS regimen. Early steroid avoidance in LT showed a high incidence of AR (26). Basiliximab is a chimeric monoclonal antibody with high affinity for the CD25 chain of the interleukin-2 receptor.…”

Section: Discussionmentioning

confidence: 99%

A national report from China Liver Transplant Registry: steroid avoidance after liver transplantation for hepatocellular carcinoma

Wei

Gao

Zhuang

et al. 2017

Chinese Journal of Cancer Research

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“…The efficacy and safety of BXM have been established in several studies conducted in DDLT patients (4–7). However, only a few studies have evaluated BXM as an additional induction agent in LDLT with an emphasis on decreased episodes of ACR, and some of these studies were conducted to eliminate or reduce calcineurin inhibitor or steroid treatment in the early period after LDLT (13–16). In the current study, all the patients were given calcineurin inhibitor and steroid with traditional or reduced doses after LDLT, and the majority of the biopsy‐confirmed ACR cases in the control group had higher histopathological grades than those in the BXM group.…”

Section: Discussionmentioning

confidence: 99%

Unique histopathological features of graft biopsies with liver function abnormalities in living donor liver transplant patients receiving basiliximab induction therapy

Sato

Sekiguchi

Kawagishi

et al. 2011

Clinical Transplantation

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Induction with basiliximab (BXM) has been confirmed as an effective treatment regimen for prophylaxis of acute cellular rejection (ACR). From 1991 to 2008, 116 living donor liver transplantations (LDLTs) were performed. Among these, 50 were included in this study. We compared calcineurin inhibitor plus steroid treatment without BXM (n = 14, control group) and with BXM (n = 36, BXM group). Although the rates of biopsied patients with abnormal serum biochemical tests (SBTs) were similar in the control (10/14, 71.4%) and BXM (21/36, 58.3%) groups, ACR was diagnosed in 9/10 (90.0%) patients in the control group compared with 4/21 (19.0%) patients in the BXM group. In accordance with the histopathological diagnosis, there was a significant difference in the ratios of peripheral CD4(+) CD25(+) T cells at five wk after LDLT between patients with and without ACR in the BXM group. Next, we divided the 32 patients without ACR in the BXM group into two groups: biopsied patients with abnormal SBTs and non-biopsied patients. The donor age of the biopsied patients was significantly higher than that of the non-biopsied patients. Induction with BXM reduced the incidence of ACR, and unique pathological phenomena responsible for graft dysfunction after LDLT with an increased incidence of abnormal SBTs were observed.

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A Safe Immunosuppressive Protocol in Adult-to-Adult Living Related Liver Transplantation

Cited by 12 publications

References 12 publications

Induction immunosuppression in liver transplantation: a review

Induction immunosuppression in liver transplantation: a review

A national report from China Liver Transplant Registry: steroid avoidance after liver transplantation for hepatocellular carcinoma

Unique histopathological features of graft biopsies with liver function abnormalities in living donor liver transplant patients receiving basiliximab induction therapy

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