Adverse Effect of Low-Dose Prophylactic Human Recombinant Leukocyte Interferon-Alpha Treatment in Renal Transplant Recipients

Kovařík, Josef; Mayer, Gert; Pohanka, E; Schwarz, Michaela; Traindl, O; H, Graf; Smolen, J S

doi:10.1097/00007890-198802000-00031

Cited by 117 publications

(35 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is no reason, however, to deny the inherent ability of IFN-␣ to tip the scales toward rejection. This has been well documented in experimental models 21 and by reports of the devastating complications of IFN-␣ therapy in human kidney transplant recipients, 22,23 including some of our own patients. 24 The most obvious explanation for the disparity in outcome with liver and kidney transplantation derives from the retarded metabolism of tacrolimus 29,30 and, to a lesser degree, CyA, that occurs with the hepatic dysfunction that is a frequent finding in the post-OLT population, especially so with the supervention of hepatitis.…”

Section: Acute Allograft Rejection and Alfa Interferonmentioning

confidence: 70%

Incidence and severity of acute allograft rejection in liver transplant recipients treated with alfa interferon

et al. 1998

View full text Add to dashboard Cite

Section: Acute Allograft Rejection and Alfa Interferonmentioning

confidence: 70%

Incidence and severity of acute allograft rejection in liver transplant recipients treated with alfa interferon

et al. 1998

View full text Add to dashboard Cite

“…IFN-a also induces cytokine gene expression, increased cell surface expression of HLA antigens, and enhanced function of natural killer cells, cytotoxic T cells and monocytes [23]. These immunostimulant effects can result in enhanced allograft rejection when IFN-a is given to transplant recipients [24][25][26][27][28]. Use of IFN-a in dialysis patients with chronic HCV infection seems to be a safer approach and facilitates renal transplantation.…”

Section: Discussionmentioning

confidence: 99%

Sustained Virological and Histological Response with Pretransplant Interferon Therapy in Renal Transplant Patients with Chronic Viral Hepatitis C

Huraib¹,

Iqbal²,

Tanimu³

et al. 2001

Am J Nephrol

View full text Add to dashboard Cite

Patients who are anti-HCV positive before renal transplantation (Tx) have a significantly increased risk of posttransplant liver disease. We conducted a prospective, controlled study to evaluate the posttransplant outcome of renal graft candidates with HCV-associated chronic hepatitis (n = 30). Patients were randomly assigned to either of two groups. All patients on enrollment underwent liver biopsy, which showed mild-to-moderate hepatitis activity (mean 4.1, range 2–6). Half the patients received interferon-alpha (IFN-a) administered at a dosage of 3 million units three times weekly for 1 year. Liver biopsy was repeated for treated patients at the end of IFN-a treatment. Of these, 11 patients received renal transplant (group A). The other half did not receive IFN-a and to date 10 patients have been transplanted (group B). Renal transplant recipients were prospectively followed for a period of 12 months and a follow-up liver biopsy was also done at the end of this period (end of study). Biochemical and virological responses were evaluated and the histologic activity index (HAI) scoring according to Knodell was assessed. The mean pretreatment serum HCV RNA level was 1.14 ± 0.84 and 1.0 ± 0.89 mEq/ml for groups A and B, respectively (bDNA assay sensitivity threshold is <0.2 mEq/ml). HCV RNA became undetectable in 4 patients of group A. At the end of study period the mean quantitative HCV RNA titers were 1.43 ± 4.07 and 15.18 ± 11.08 mEq/ml in groups A and B, respectively (p < 0.0001). In group A, the mean HAI score decreased from 4.27 ± 1.19 to 1.64 ± 0.67 after IFN-a treatment (p < 0.0001). This score was maintained till the end of the study period with a mean of 1.82 ± 0.6. Mean HAI score of group B on enrollment was 3.9 ± 1.2 and at the end of study increased to 5.5 ± 1.35 (p = 0.01). There was statistically significant difference (p value less than 0.0001) between the HAI scores at the end of the study period between the two groups. These results demonstrate that interferon therapy while on dialysis is associated with less viremia and decreased progression of chronic liver disease in renal transplant patients with hepatitis C.

show abstract

“…Vaccina tion against CMV is still under discussion even if recent studies performed in dialysis patients are encouraging [3,18]. Interferon-a has been used with success, but was rap idly abandoned because of the occurrence of irreversible rejections [4,5], The current group of drugs used against CMV includes acyclovir (low or high doses), ganciclovir, polyvalent Igs, CMV hyperimmune globulins or a combi nation of some of these products. Due to (i) the absence of an oral form of ganciclovir when our study was designed, and (ii) because the dose of polyvalent Igs can be as high as 1 g/kg/injection and can be hazardous in patients with renal dysfunction, we chose to compare the efficacity of high doses of acyclovir, i.e.…”

Section: Discussionmentioning

confidence: 99%

CMV Prophylaxis in High-Risk Renal Transplant Patients (D+/R-) by Acγclovir with or without Hyperimmune (CMV) Immunoglobulins: A Prospective Study

Rostaing

Martinet²,

Cisterne³

et al. 1997

Am J Nephrol

View full text Add to dashboard Cite

In this prospective randomized study including 28 patients, we show that, in cytomegalovirus (CMV)-seronegative renal transplant recipients (R-) receiving a CMV-seropositive graft (D+), high doses of acyclovir (ACV, i.e. 3,200 mg/day) during the first 3 months after transplantation were as efficient as hyperimmune CMV immunoglobulins (CMV Igs) plus high doses of ACV regarding the prophylaxis of CMV primoinfection. Fifty-four percent of the patients in the ACV arm and 50% in the other arm presented at least one episode of viremia (n.s.). The incidence of CMV disease was 31% in the ACV group and 20% in the ACV + CMV Ig group (n.s.). By comparison with historical controls (no prophylaxis), we found that ACV with or without CMV Ig significantly delayed and significantly decreased the rate of CMV disease, although the severity score was not statistically different. Moreover, high doses of ACV were far less expensive than their combination with hyperimmune CMV Igs. Thus, until oral ganciclovir is available for the prophylaxis of primary CMV infection in renal transplant patients, we recommend the use of high doses of ACV for the first 3 months after transplantation in high-risk renal transplant patients, i.e. D+/R-.

show abstract

Adverse Effect of Low-Dose Prophylactic Human Recombinant Leukocyte Interferon-Alpha Treatment in Renal Transplant Recipients

Cited by 117 publications

References 0 publications

Incidence and severity of acute allograft rejection in liver transplant recipients treated with alfa interferon

Incidence and severity of acute allograft rejection in liver transplant recipients treated with alfa interferon

Sustained Virological and Histological Response with Pretransplant Interferon Therapy in Renal Transplant Patients with Chronic Viral Hepatitis C

CMV Prophylaxis in High-Risk Renal Transplant Patients (D+/R-) by Acγclovir with or without Hyperimmune (CMV) Immunoglobulins: A Prospective Study

Contact Info

Product

Resources

About

Adverse Effect of Low-Dose Prophylactic Human Recombinant Leukocyte Interferon-Alpha Treatment in Renal Transplant Recipients

Cited by 117 publications

References 0 publications

Incidence and severity of acute allograft rejection in liver transplant recipients treated with alfa interferon

Incidence and severity of acute allograft rejection in liver transplant recipients treated with alfa interferon

Sustained Virological and Histological Response with Pretransplant Interferon Therapy in Renal Transplant Patients with Chronic Viral Hepatitis C

CMV Prophylaxis in High-Risk Renal Transplant Patients (D+/R-) by Ac&gamma;clovir with or without Hyperimmune (CMV) Immunoglobulins: A Prospective Study

Contact Info

Product

Resources

About

CMV Prophylaxis in High-Risk Renal Transplant Patients (D+/R-) by Acγclovir with or without Hyperimmune (CMV) Immunoglobulins: A Prospective Study