Steroid elimination within 24 hours after orthotopic liver transplantation: Effectiveness and tolerability

Lin Wei Wu, Zhi Yong Guo, Qiang Tai, Wei Qiang Ju, Dong Ping Wang, An Bin Hu, Xiao Feng Zhu, Xiao Shun He

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

BACKGROUND: Steroids have been the mainstay of immunosuppressive regimen in liver transplantation. However, the use of steroids is associated with various post-transplant complications. This study evaluated the efficacy and safety of reduced immunosuppressive regimen with steroids (steroid elimination within 24 hours post-transplant) in a cohort of Chinese liver transplant recipients. METHODS: Seventy-six patients in line with the selection criteria were enrolled in this prospective study. All patients received anti-IL-2 receptor antibody induction and tacrolimusbased maintenance therapy. The recipients were divided into two groups according to the duration of steroid use: 40 transplant in a 3-month withdrawal group and the remaining 36 in a 24-hour elimination group. Recipient survival, postoperative infections, biopsy-proven acute rejection and steroidresistant acute rejection, non-healing wound, recurrence of hepatitis B virus (HBV) and hepatocellular carcinoma (HCC), de novo diabetes, hyperlipidemia and hypertension were assessed in the two groups. RESULTS: There was no significant difference in patient survival, incidence of acute rejection episodes and hyperlipidemia, and recurrence of HBV and HCC between the two groups. However, the incidence rates of post-transplant infection, non-healing wound, de novo diabetes and hypertension were significantly lower in the 24-hour elimination group than in the 3-month withdrawal group (all P values <0.05). CONCLUSION: Under anti-IL-2 receptor antibody induction and tacrolimus-based maintainance, steroid elimination within 24 hours post-transplant is associated with reduced steroidrelated complications without increasing the risk of rejection.

Original languageEnglish (US)
Pages (from-to)137-142
Number of pages6
JournalHepatobiliary and Pancreatic Diseases International
Volume11
Issue number2
DOIs
StatePublished - Apr 2012

Keywords

  • Immunosuppression
  • Liver transplantation
  • Side effects
  • Steroid

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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