Daclizumab Induction Therapy Associated With Tacrolimus-MMF Has Better Outcome Compared to Tacrolimus-MMF Alone in Pediatric Living Donor Liver Transplantation

Schüler, S.; Wiederkehr, Julio Cesar; Coelho-lemos, I C.m.; Avilla, Sylvio Gilberto Andrade; Schulz, Claudia

doi:10.1097/00007890-200407271-01260

Cited by 10 publications

(34 citation statements)

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“…While there was no significant difference in rejection episodes at 6 and 12 months between the two groups, the HCV-negative group treated with basiliximab did experience a statistically significant reduction in acute rejection at 6 months (P = 0.03). Several retrospective reviews have demonstrated significant differences in ACR with basiliximab [13][14][15] or daclizumab [16] induction in addition to standard CNI-based regimens. Ramirez and colleagues performed the largest series in this group, examining 46 patients after OLT receiving basiliximab induction in the setting of a tacrolimus and steroid-based regimen, with or without MMF, compared with 46 historic controls receiving dual or triple standard immunosuppression.…”

Section: Induction As An Adjunct To Conventional Immunosuppressionmentioning

confidence: 99%

Induction immunosuppression in liver transplantation: a review

Turner

Knechtle

2013

Transpl Int

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Summary Antibody therapy for induction is seldom used in liver transplantation in the United States, but continues to be used in approximately 10% of patients. The most commonly used antibody at the current time is basiliximab (Simulect, Novartis) and is used in adults with renal dysfunction at the time of liver transplantation with the intention of delaying introduction of calcineurin‐inhibitors. In children, the same antibody is commonly used in order to reduce rates of acute rejection. Most patients, adult and pediatric, are treated with initially higher levels of tacrolimus rather than antibody induction.

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Section: Induction As An Adjunct To Conventional Immunosuppressionmentioning

confidence: 99%

Induction immunosuppression in liver transplantation: a review

Turner

Knechtle

2013

Transpl Int

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“…Incidence of chronic rejection was 1.8% in both groups, with a single case of posttransplant lymphoproliferative disorder (PTLD) in the induction group. Induction with daclizumab was also shown to be safe and was associated with a lower incidence of acute rejection in LRLT [26]. Replacement of tacrolimus by sirolimus was studied in a highly selected group of recipients of liver transplants.…”

Section: Immunosuppressionmentioning

confidence: 99%

Historical review and perspectives in pediatric transplantation

Otte¹

2006

Current Opinion in Organ Transplantation

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Purpose of reviewRecent progress in organ transplantation in children is illustrated by analysis of the most informative papers published during [2005][2006]. Recent findingsThe review focuses on immunosuppression, steroid withdrawal or avoidance, living-related transplantation, long-term survival, drug-related nephrotoxicity, growth, and quality of life in solid organ transplantation. Summary Research on better, more selective, and safer immunosuppression must be pursued as well as the search for surrogate markers of tolerance. Long-term analysis is needed of quality of life beyond 10-15 years after transplantation. Abbreviations cGFR calculated glomerular filtration rate HRQL health-related quality of life IMD inherited metabolic disorder LRLT living-related liver transplantation OLT orthotopic liver transplant PELD Pediatric End-Stage Liver Disease scoring system PTLD posttransplant lymphoproliferative disorder rhGH recombinant human growth hormone UNOS United Network for Organ Sharing ß

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“…The humanized murine antibody daclizumab, derived from a recombinant gene in which the hypervariable region from the mouse antibody anti-Tac has been introduced into a human framework, and the chimeric antibody basiliximab, again derived from a recombinant gene, but one in which the entire variable region is derived from the mouse, whereas the constant region is human, are directed against the a-chain (CD25) of the IL-2 receptor, which is expressed on activated T cells [8,9]. As inhibitors of IL-2 binding, these monoclonal IgG1 antibodies prevent acute cellular rejection by inhibiting IL-2-driven T-cell proliferation [10 ].…”

Section: The Induction Agentsmentioning

confidence: 99%

“…In recent studies, daclizumab was administered at a dose of 1-2 mg/kg intraoperatively and a second dose on postoperative days 4-14. One study used an additional five doses every 2 weeks after transplantation [9]. Basiliximab was given at a dose of 20 mg intraoperatively and on postoperative day 4 [10 ].…”

Section: The Induction Agentsmentioning

confidence: 99%

“…A prospective nonrandomized study including 30 paediatric patients after living-related liver transplantation compared the use of tacrolimus preceded by daclizumab induction, MMF and steroids (average follow-up of 6 months) compared with tacrolimus, MMF and steroids (average follow-up of 14 months) [9]. The data reported show a significant reduction in the one month rate of acute rejection episodes using daclizumab induction despite a significantly lower tacrolimus level on postoperative day 14.…”

Section: Anti-il2 Antibodiesmentioning

confidence: 99%

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The use of induction agents in liver transplantation

Grotelueschen

Fischer

Rogiers

2006

Current Opinion in Organ Transplantation

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Purpose of reviewDespite improvements in early graft survival, late graft loss through chronic rejection and morbidity and mortality as a result of long-term treatment with immunosuppressive medications is a major concern. New drugs have facilitated new treatment protocols with the delayed or reduced application of calcineurin inhibitors or steroid avoidance. This review focuses on recent data concerning the use of induction agents in liver transplantation. Recent findingsClinical studies using induction agents have demonstrated their safety and efficacy, and show promise for a beneficial outcome in liver transplant patients. IL-2 receptor antibodies allow a reduction of maintenance immunosuppression and reduce side effects, such as diabetes or renal impairment. Several studies using IL-2 receptor antibodies have also shown a lower incidence of acute rejection episodes in paediatric patients. Thymoglobulin has been used primarily in hepatitis C-positive patients, and studies have shown a positive effect on virus replication without significant recurrence of hepatitis C. Alemtuzumab has shown promising results regarding acute rejection episodes and renal function in a low-dose calcineurin inhibitor protocol. SummaryThe use of induction agents in liver transplantation is a promising strategy to reduce acute rejection episodes, maintenance immunosuppression, and prevent side effects without affecting patient and graft survival.

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Daclizumab Induction Therapy Associated With Tacrolimus-MMF Has Better Outcome Compared to Tacrolimus-MMF Alone in Pediatric Living Donor Liver Transplantation

Cited by 10 publications

References 0 publications

Induction immunosuppression in liver transplantation: a review

Induction immunosuppression in liver transplantation: a review

Historical review and perspectives in pediatric transplantation

The use of induction agents in liver transplantation

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