Twenty-four hour steroid avoidance immunosuppressive regimen in liver transplant recipients

Wei Qiang Ju, Zhi Yong Guo, Xiaoting Ling, Xiaoshun He, Lin Wei Wu, Qiang Tai, An Bin Hu, Ming Han, Xiao Feng Zhu

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Objectives: To investigate the efficacy and safety of an immunosuppressive regimen of steroid avoidance in combination with induction therapy and tacrolimus in liver transplant recipients. Materials and Methods: Eighty-two adult liver transplant recipients were randomized into 2 groups: standard protocol group (n=41) in which steroids were withdrawn 3 months after the operation, and a 24-hour steroid avoidance group (n=41) in which steroids were eliminated within 24-hours. The incidence of acute rejections, infections (bacterial, fungal, and cytomegalovirus), and metabolic complications were analyzed between the groups. Results: The incidence of early posttransplant diabetes mellitus and the average dosage of insulin consumption among diabetic recipients were significantly higher in recipients in the standard protocol group than in the 24-hour avoidance group (P <.05). In addition, the incidence of hypertension and infection during the follow-up were also higher in patients of the standard protocol group (P <.05). The incidence of hypertension in the early posttransplant period, hyperlipemia, and acute rejection during the follow-up were comparable between the groups (P >.05). Conclusions: Twenty-four hour steroid avoidance combined with induction therapy and tacrolimus maintenance is a safe and efficient immunosuppression strategy that can significantly reduce posttransplant infections and other complications owing to long-term use of steroids, without increasing the risk of acute rejection.

Original languageEnglish (US)
Pages (from-to)258-262
Number of pages5
JournalExperimental and Clinical Transplantation
Volume10
Issue number3
DOIs
StatePublished - Jun 1 2012

Keywords

  • Basiliximab
  • Immunosuppression
  • Liver transplant
  • Steroids
  • Tacrolimus

ASJC Scopus subject areas

  • Transplantation

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