Antibody induction versus corticosteroid induction for liver transplant recipients

Abstract

Antibody induction versus corticosteroid induction for liver transplant recipients.

Review on immunosuppression in liver transplantation

“…Antibody induction along with delayed CNI introduction can be used to preserve renal function in LT recipients and reduce renal dysfunction in those with impairment [24] . Overall, no significant increase in adverse side effects was observed in solid transplant recipients receiving antibody induction [23,25] . However, their use [52,55] …”

“…Less frequent diabetes mellitus, less CMV infections and higher glomerular filtration rate were observed among patients receiving IL2Ra vs those who received corticosteroids as induction therapy. The two IL2Ra agents, basiliximab and daclizumab did not differ in the mentioned advantages when analyzed by Penninga et al [23] and may be used interchangeably.…”

“…Antibody administration has been used for induction therapy in "steroidfree" protocols where there is elimination of corticosteroid in the induction of immunosuppression in LT patients [21,22] . Compared with corticosteroid induction, less hyper glycemia and diabetes and less cytomegalovirus (CMV) infections are found with antibody induction [17,23] . This "steroidfree" strategy may be especially beneficial for patients with hepatitis C patients and for those with diabetes and hypertension.…”

“…For ATGAM a higher dose of 15 mg/kg per day is usually used 2 Daclizumab (Zenapax ® ) [23,115] IL-2Ra, monoclonal antibody…”

“…For induction the first dose of 1 mg/kg is given within 24 h before Tx and 4 more doses are given after Tx with 2 wk intervals Withdrawn from the market because of reduced use, no longer available Basiliximab (Simulect ® ) [23,113,114] IL-2Ra, monoclonal antibody There are insufficient data regarding the possible increased risk of post transplantation lymphoproliferative disorders (PTLD) following rATG induction in LT patients. However, the overall incidence of PTLD in kidney and heart transplant recipients receiving rATG induction therapy was low and the effect of prophylactic antiviral therapy on the risk reduction has been supported [42] .…”