Steroid-free immunosuppression after liver transplantation does not increase the risk of graft fibrosis.

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  • Additional Information
    • Source:
      Publisher: Elsevier Science Inc Country of Publication: United States NLM ID: 0243532 Publication Model: Print Cited Medium: Internet ISSN: 1873-2623 (Electronic) Linking ISSN: 00411345 NLM ISO Abbreviation: Transplant Proc Subsets: MEDLINE
    • Publication Information:
      Publication: New York, N.Y. : Elsevier Science Inc.
      Original Publication: New York Stratton.
    • Subject Terms:
      Immunosuppressive Agents/*therapeutic use ; Liver Cirrhosis/*epidemiology ; Liver Transplantation/*immunology; Adrenal Cortex Hormones/therapeutic use ; Adult ; Alanine Transaminase/blood ; Azathioprine/therapeutic use ; Bilirubin/blood ; Creatinine/blood ; Cyclosporine/therapeutic use ; Follow-Up Studies ; Humans ; Liver Cirrhosis/pathology ; Liver Transplantation/adverse effects ; Liver Transplantation/mortality ; Liver Transplantation/pathology ; Postoperative Complications/epidemiology ; Risk Factors ; Safety ; Survival Rate ; Survivors ; Time Factors
    • Abstract:
      Background: Steroid-free immunosuppression after liver transplantation (OLT) is effective and safe in the short and mid terms. However, research has shown a higher risk for late fibrosis among pediatric liver transplant recipients who have steroids withdrawn. Our aim was to test this hypothesis in the adult population.
      Patients and Methods: The study involved 27 adults, 14 of whom were on a regimen of cyclosporine, azathioprine, and steroid (group A) and 13 cyclosporine and azathioprine steroid-free immunosuppression (group B). The main end point of the study was liver graft histology in the late stage after OLT, with emphasis on the evolution of fibrosis, which was scored according to Ishak. The secondary end points were patient and graft survivals, liver and kidney functions, rejection rates, infections, and tumors, as well as the incidences of cardiovascular and metabolic complications.
      Results: After a mean follow-up of 89.3 +/- 21 months, the mean fibrosis scores did not differ between the 2 groups (2.2 +/- 1.5 vs 1.9 +/- 1.2; P = NS). One group A patient developed a severe acute rejection episode. The 7-year patient and graft survivals, as well as liver and kidney functions, incidence of infections, and cardiovascular and metabolic complications were comparable. Patients receiving steroids showed a trend toward an higher rate of de novo malignancies.
      Conclusion: Steroid-free immunosuppression did not increase the risk of graft fibrosis in the long term.
      (Copyright (c) 2010 Elsevier Inc. All rights reserved.)
    • Accession Number:
      0 (Adrenal Cortex Hormones)
      0 (Immunosuppressive Agents)
      83HN0GTJ6D (Cyclosporine)
      AYI8EX34EU (Creatinine)
      EC 2.6.1.2 (Alanine Transaminase)
      MRK240IY2L (Azathioprine)
      RFM9X3LJ49 (Bilirubin)
    • Publication Date:
      Date Created: 20100611 Date Completed: 20101029 Latest Revision: 20131121
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/j.transproceed.2010.03.118
    • Accession Number:
      20534270