Interleukin 2 receptor antagonists for liver transplant recipients: A systematic review and meta-analysis of controlled studies

Goralczyk, Armin D.; Hauke, Nicola; Bari, N; Tsui, Tung Yu; Lorf, Thomas; Obed, Aiman

doi:10.1002/hep.24385

Cited by 63 publications

(62 citation statements)

References 35 publications

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“…This may be because CSA and RAP were administered in only a few cases, and only some patients switch immunosuppressants from FK506 to CSA or RAP. However, IL‐2Ra, a commonly used antibody, may have certain protective effects against NODAT onset . In the present study, IL‐2Ra administration reduced the risk of NODAT onset, with an OR of 0.427.…”

Section: Discussionsupporting

confidence: 45%

New‐onset diabetes after liver transplantation and its impact on complications and patient survival

Zhang

Chen

et al. 2015

Journal of Diabetes

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Section: Discussionsupporting

confidence: 45%

New‐onset diabetes after liver transplantation and its impact on complications and patient survival

Zhang

Chen

et al. 2015

Journal of Diabetes

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“…A multicenter trial lately described that steroid‐free immunosuppression has no clear advantage over other regimens incorporating steroids , which was in accordance with our preceding studies . Most of our SLKT recipients received an interleukin‐2 receptor antagonist and/or lymphocyte‐depleting agent for induction, for which their use in HCV+ patients is yet to be determined . The influence of mycophenolate mofetil on recurrent HCV has also been the subject of conflicting results .…”

Section: Discussionsupporting

confidence: 79%

Excessive immunosuppression as a potential cause of poor survival in simultaneous liver/kidney transplantation for hepatitis C

et al. 2014

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SummaryAppropriate recipient selection of simultaneous liver/kidney transplantation (SLKT) remains controversial. In particular, data on liver graft survival in hepatitis C virus-infected (HCV+) SLKT recipients are lacking. We conducted a singlecenter, retrospective study of HCV+ SLKT recipients (N = 25) in comparison with HCVÀ SLKT (N = 26) and HCV+ liver transplantation alone (LTA, N = 296). Despite backgrounds of HCV+ and HCVÀ SLKT being similar, HCV+ SLKT demonstrated significantly impaired 5-year liver graft survival of 35% (HCVÀ SLKT, 79%, P = 0.004). Compared with HCV+ LTA, induction immunosuppression was more frequently used in HCV+ SLKT. Five-year liver graft survival rate for HCV+ SLKT was significantly lower than that for LTA (35% vs. 74%, respectively, P < 0.001). Adjusted hazard ratio of liver graft loss in HCV+ SLKT was 4.9 (95% confidence interval 2.0-12.1, P = 0.001). HCV+ SLKT recipients were more likely to succumb to recurrent HCV and sepsis compared with LTA (32% vs. 8.8%, P < 0.001 and 24% vs. 8.8%, P = 0.030, respectively). Ten HCV+ SLKT recipients underwent anti-HCV therapy for recurrent HCV; only 1 achieved sustained virological response. HCV+ SLKT is associated with significantly decreased long-term prognosis compared with HCVÀ SLKT and HCV+ LTA.

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“…The rates of biopsy‐proven acute rejection and patient and graft survival were reportedly similar. These conclusions were supported by a recent meta‐analysis18; however, at least 1 study has reported no benefit to renal function from an anti–IL‐2RA induction regimen 19…”

Section: Practice Of Lt Immunosuppression In the United Statesmentioning

confidence: 85%

Present state of immunosuppressive therapy in liver transplant recipients

2011

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Key Points 1. Our increasing understanding of the signaling pathways and cellular interactions in transplant immunobiology has facilitated targeted strategies using novel immunosuppressive agents. 2. The pattern of immunosuppressive drug use in the United States continues to change, and the changes include the use of antibody induction therapy and the agents used in maintenance therapy. 3. The driving forces behind the development of new immunosuppressive regimens are the long-term complications of current immunosuppressive regimens (particularly renal dysfunction and metabolic disturbances). Liver Transpl 17:S1-S9, 2011. V C 2011 AASLD.Received July 27, 2011; accepted August 9, 2011.Recent advances in molecular and cellular immunology have further unraveled the interactions between antigen-presenting cells (APCs), T cells, and B cells. These advances include the elucidation of pathways involved in T cell activation and apoptosis, the identification of novel regulatory cells (including T regulatory cells and suppressive APCs), and a greater appreciation of the complex interactions between innate and adaptive immunity. Furthermore, the elucidation of the triggers of B cell activation and antibody synthesis has allowed the development of B cell-specific immunosuppression, although the impact of donor-specific antibodies and B cells on liver transplantation (LT) is still being assessed. Nevertheless, the focus of immunosuppressive drug development has continued to be the T cell. Thus, we briefly review our current understanding of T cell activation and proliferation as well as the mechanisms of action of immunosuppressive agents.

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Interleukin 2 receptor antagonists for liver transplant recipients: A systematic review and meta-analysis of controlled studies

Abstract: The use of IL-2Ra is associated with a lower incidence of acute rejection after transplantation. Concomitant immunosuppression can be reduced, avoiding long-term side effects of immunosuppression.

Cited by 63 publications

References 35 publications

New‐onset diabetes after liver transplantation and its impact on complications and patient survival

New‐onset diabetes after liver transplantation and its impact on complications and patient survival

Excessive immunosuppression as a potential cause of poor survival in simultaneous liver/kidney transplantation for hepatitis C

Present state of immunosuppressive therapy in liver transplant recipients

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