Complications in Immunosuppressive Therapy of Liver Transplant Recipients

Gruttadauria, Salvatore; Francesco, Fabrizio di; Pagano, Domenico; Vizzini, Giovanni; Cintorino, Davide; Spada, Marco; Tuzzolino, Fabio; Gridelli, Bruno

doi:10.1016/j.jss.2010.09.035

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…Boluses of high-dose steroids are routinely administered during and after the operation for the control of acute cellular rejection in many liver transplant centers. However, prolonged use of steroids is associated with multiple severe side effects including hypertension, hyperlipidemia, obesity, diabetes mellitus, osteoporosis, infectious complications, and particularly growth retardation in children [6]. In addition, hepatitis C virus (HCV) and tumor recurrence upon OLT should also be taken into consideration when patients are exposed to high-dose long-term steroids [7–10].…”

Section: Introductionmentioning

confidence: 99%

Role of steroid minimization in the tacrolimus-based immunosuppressive regimen for liver transplant recipients: a systematic review and meta-analysis of prospective randomized controlled trials

Lü

et al. 2014

Hepatol Int

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To evaluate the efficacy and safety of early steroid withdrawal or steroid avoidance in the tacrolimus (Tac)-based immunosuppressive regimen for liver transplant recipients. According to the requirements of the Cochrane systematic review, a thorough literature search was performed in the PubMed/MEDLINE and Cochrane electronic databases between 1995 and 2011 using the key words “liver transplantation,” “Tac,” and “steroid free” or “steroid withdrawal,” restricting articles to the English language. Data were processed for a meta-analysis by Stata 12 software. Altogether 17 prospective randomized controlled trials containing 1,980 transplanted patients were included in this study. The overall pooled RR estimates of 1-, 2-, 3-, and 5-year patient and graft survival rates were 0.985, 0.998, 0.995, and 1.100 (95 % CI 0.925–1.048, 0.934–1.067, 0.894–1.107, and 0.968–1.250, respectively), as well as 0.998, 0.993, 0.945, and 1.053, respectively (95 % CI 0.928–1.072, 0.902–1.092, 0.833–1.072, and 0.849–1.307, respectively). The other pooled RR estimates of acute rejection and chronic rejection rates for all enrolled studies were 1.077 and 0.311 (95 % CI 0.864–1.343 and 0.003–37.207). As for secondary predictors, the pooled RR estimates such as HCV recurrence, HCC recurrence, diabetes, hypertension, kidney dysfunction, bacterial infection, and CMV were 1.101, 1.403, 1.836, 1.607, 0.842, 1.096, and 2.280, respectively (95 % CI 0.964–1.257, 0.422–4.688, 1.294–2.606, 0.926–1.228, 0.693–1.022, 0.783–1.533, and 1.500–3.465, respectively). There were no differences between the steroid group and steroid-free group for all clinical observational indices except for the incidence of diabetes (p = 0.001) and CMV infection (p < 0.001). In summary, our study indicate that rapid discontinuation of steroid in the Tac-based immunosuppressive regimen may not lead to an increased risk of morbidity and rejection rate.Electronic supplementary materialThe online version of this article (doi:10.1007/s12072-014-9523-y) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Role of steroid minimization in the tacrolimus-based immunosuppressive regimen for liver transplant recipients: a systematic review and meta-analysis of prospective randomized controlled trials

Lü

et al. 2014

Hepatol Int

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“…Currently, the recipients have to rely on taking strong lifelong immunosuppressive agents to prevent rejection of these transplanted cells. These drugs can cause severe adverse events such as renal failure, life-threatening infections, and other malignancies [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Efficient Cardiac Differentiation of Human Amniotic Fluid-Derived Stem Cells into Induced Pluripotent Stem Cells and Their Potential Immune Privilege

Fang

Wang

Gao

et al. 2020

IJMS

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Mature mammalian hearts possess very limited regenerative potential. The irreversible cardiomyocyte loss after heart injury can lead to heart failure and death. Pluripotent stem cells (PSCs) can differentiate into cardiomyocytes for cardiac repair, but there are obstacles to their clinical application. Among these obstacles is their potential for post-transplant rejection. Although human amniotic fluid-derived stem cells (hAFSCs) are immune privileged, they cannot induce cardiac differentiation. Thus, we generated hAFSC-derived induced PSCs (hAFSC-iPSCs) and used a Wnt-modulating differentiation protocol for the cardiac differentiation of hAFSC-iPSCs. In vitro studies using flow cytometry, immunofluorescence staining, and patch-clamp electrophysiological study, were performed to identify the characteristics of hAFSC-iPSC-derived cardiomyocytes (hAFSC-iPSC-CMs). We injected hAFSC-iPSC-CMs intramuscularly into rat infarcted hearts to evaluate the therapeutic potential of hAFSC-iPSC-CM transplantation. At day 21 of differentiation, the hAFSC-iPSC-CMs expressed cardiac-specific marker (cardiac troponin T), presented cardiomyocyte-specific electrophysiological properties, and contracted spontaneously. Importantly, these hAFSC-iPSC-CMs demonstrated low major histocompatibility complex (MHC) class I antigen expression and the absence of MHC class II antigens, indicating their low immunogenicity. The intramyocardial transplantation of hAFSC-iPSC-CMs restored cardiac function, partially remuscularized the injured region, and reduced fibrosis in the rat infarcted hearts. Therefore, hAFSC-iPSCs are potential candidates for the repair of infarcted myocardium.

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Steroid-free Liver Transplantation Using Rabbit Antithymocyte Globulin Induction in 500 Consecutive Patients

Yoo

Vanatta²,

Modanlou³

et al. 2015

Transplantation

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Complications in Immunosuppressive Therapy of Liver Transplant Recipients

Cited by 5 publications

References 15 publications

Role of steroid minimization in the tacrolimus-based immunosuppressive regimen for liver transplant recipients: a systematic review and meta-analysis of prospective randomized controlled trials

Role of steroid minimization in the tacrolimus-based immunosuppressive regimen for liver transplant recipients: a systematic review and meta-analysis of prospective randomized controlled trials

Efficient Cardiac Differentiation of Human Amniotic Fluid-Derived Stem Cells into Induced Pluripotent Stem Cells and Their Potential Immune Privilege

Steroid-free Liver Transplantation Using Rabbit Antithymocyte Globulin Induction in 500 Consecutive Patients

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