Reversal of Early Acute Rejection With Increased Doses of Tacrolimus in Liver Transplantation

Boillot, Olivier; Viale, Jean–Paul; Gratadour, P; Méeus, Pierre; Souraty, Pierre; Derf, Y Le; Mechet, Isabelle; Scoazec, Jean‐Yves; Berger, Fran oise; Paliard, P

doi:10.1097/00007890-199811150-00012

Cited by 18 publications

(8 citation statements)

References 6 publications

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“…Previous attempts at total steroid avoidance have generally included at least one anhepatic dose, and steroids were required to treat rejection episodes (15)(16)(17)(18)(19). Tacrolimus has been shown to effectively reverse rejection and has been used as monotherapy after early steroid withdrawal (14,20). This series demonstrates the efficacy of tacrolimus monotherapy as early as 2 weeks posttransplant in steroid-free patients and yields similar results to triple immunosuppressive protocols including steroids (21).…”

Section: Resultsmentioning

confidence: 83%

Steroid-free liver transplantation using rabbit antithymocyte globulin and early tacrolimus monotherapy1

et al. 2003

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Section: Resultsmentioning

confidence: 83%

Steroid-free liver transplantation using rabbit antithymocyte globulin and early tacrolimus monotherapy1

et al. 2003

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“…A substantial number of acute rejections reversed under increased doses of tacrolimus without the need of steroids. The results of a French pilot study16 showed that by using increased tacrolimus doses alone, early acute rejection episodes, including the severe grade, can be resolved, while tacrolimus toxicity remains limited.…”

Section: Discussionmentioning

confidence: 99%

Corticosteroid-free immunosuppression with tacrolimus following induction with daclizumab: A large randomized clinical study

et al. 2004

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“…The treatment of acute rejection included intravenous solumedrol boluses (1000 mg/day for 3 days) or increased doses of Tac 15…”

Section: Methodsmentioning

confidence: 99%

Thymoglobulin induction in liver transplant recipients with a tacrolimus, mycophenolate mofetil, and steroid immunosuppressive regimen: A five-year randomized prospective study

et al. 2009

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This randomized, comparative study assessed the long-term efficacy and tolerability of thymoglobulin (TMG) induction in 93 liver transplant patients with an initial regimen of tacrolimus (Tac), mycophenolate mofetil (MMF), and steroids. Forty-four patients were randomly allocated to the TMGϩ group, and 49 patients were randomly allocated to the TMGϪ group. In both groups, Tac was given orally at the initial daily dose of 0.075 mg/kg twice daily, and MMF was given at the initial daily dose of 2 g/day. Steroid withdrawal was planned at 3 months after liver transplantation. The results were evaluated with respect to acute rejection incidence, patient and graft survival, graft function, and medical complications until 5 years or death for all patients. No significant differences were found between groups for the incidence of acute rejection at 5 years (11.4% versus 14.3%), 5-year patient survival (77.3% versus 87.8%), graft function, or postoperative renal function. One patient in the TMGϪ group underwent retransplantation. There was no difference between groups with respect to the incidence of medical complications, excepted for a higher rate of leukopenia in the TMGϩ group, during the 5-year follow-up. In conclusion, the results of this prospective randomized study suggest that the addition of TMG to a triple immunosuppressive regimen (Tac, MMF, and steroids) did not modify the incidence of acute rejection episodes or long-term survival and was responsible for increased leukopenia rates.

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Reversal of Early Acute Rejection With Increased Doses of Tacrolimus in Liver Transplantation

Abstract: This pilot study suggests that increasing tacrolimus dosage could be considered as treatment against early acute rejection episodes including the severe grade.

Cited by 18 publications

References 6 publications

Steroid-free liver transplantation using rabbit antithymocyte globulin and early tacrolimus monotherapy1

Steroid-free liver transplantation using rabbit antithymocyte globulin and early tacrolimus monotherapy1

Corticosteroid-free immunosuppression with tacrolimus following induction with daclizumab: A large randomized clinical study

Thymoglobulin induction in liver transplant recipients with a tacrolimus, mycophenolate mofetil, and steroid immunosuppressive regimen: A five-year randomized prospective study

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