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Article: Interleukin-2 receptor antibody (basiliximab) for immunosuppressive induction therapy after liver transplantation: A protocol with early elimination of steroids and reduction of tacrolimus dosage

TitleInterleukin-2 receptor antibody (basiliximab) for immunosuppressive induction therapy after liver transplantation: A protocol with early elimination of steroids and reduction of tacrolimus dosage
Authors
Issue Date2004
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021
Citation
Liver Transplantation, 2004, v. 10 n. 6, p. 728-733 How to Cite?
AbstractA prospective evaluation was performed to study the potential benefits of the use of interleukin-2 receptor antibody (IL-2Rab) in the induction therapy with early elimination of steroid and reduction of tacrolimus dosage in liver transplant recipients among whom 94% had chronic hepatitis B infection. Thirty-one liver transplant recipients who underwent right-lobe live donor (n = 19) or cadaveric (n = 12) liver transplantation received IL-2Rab, basiliximab 20 mg intravenously within 6 hours of graft reperfusion and on postoperative day 4 (IL-2ab group). Two doses of steroid injection were given intraoperatively and on postoperative day 1. Postoperative immunosuppression was maintained with oral tacrolimus and mycophenolate mofetil without the use of steroids. The operative outcomes were compared with those of 49 patients who received standard immunosuppressive regimen consisting of tacrolimus and corticosteroid (steroid group). The overall postoperative morbidity and hospital stay were comparable between the 2 groups. There were significantly lower incidences of postoperative new-onset diabetes (0% vs 28%, P = .011), acute cellular rejection (6% vs 27%, P = .038), and cytomegalovirus (CMV) antigenemia (0% vs 18%, P = .011) in the IL-2Rab group compared with the steroid group. The blood cholesterol level at 6 months after transplantation was significantly lower in the IL-2Rab group (Median, 4.0 vs 4.4 mmol/L, P = .007). On follow-up, none of the patients in the IL-2Rab group had hepatitis B viral breakthrough or hepatocellular carcinoma (HCC) recurrence, whereas 1 and 3 patients in the steroid group developed these complications, respectively. In conclusion, treatment of liver transplant recipients with IL-2Rab with early withdrawal of steroids and reduction of tacrolimus dosage is associated with lower incidences of postoperative new-onset diabetes, acute cellular rejection, and CMV antigenemia, as well as a lower serum cholesterol level. Further studies and long-term follow-up are required to document their potential benefits on hepatitis B and HCC recurrences. Copyright © 2004 by the American Association for the Study of Liver Diseases.
Persistent Identifierhttp://hdl.handle.net/10722/77507
ISSN
2015 Impact Factor: 3.951
2015 SCImago Journal Rankings: 1.763
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorChan, SCen_HK
dc.contributor.authorNg, IOen_HK
dc.contributor.authorLai, CLen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T07:32:39Z-
dc.date.available2010-09-06T07:32:39Z-
dc.date.issued2004en_HK
dc.identifier.citationLiver Transplantation, 2004, v. 10 n. 6, p. 728-733en_HK
dc.identifier.issn1527-6465en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77507-
dc.description.abstractA prospective evaluation was performed to study the potential benefits of the use of interleukin-2 receptor antibody (IL-2Rab) in the induction therapy with early elimination of steroid and reduction of tacrolimus dosage in liver transplant recipients among whom 94% had chronic hepatitis B infection. Thirty-one liver transplant recipients who underwent right-lobe live donor (n = 19) or cadaveric (n = 12) liver transplantation received IL-2Rab, basiliximab 20 mg intravenously within 6 hours of graft reperfusion and on postoperative day 4 (IL-2ab group). Two doses of steroid injection were given intraoperatively and on postoperative day 1. Postoperative immunosuppression was maintained with oral tacrolimus and mycophenolate mofetil without the use of steroids. The operative outcomes were compared with those of 49 patients who received standard immunosuppressive regimen consisting of tacrolimus and corticosteroid (steroid group). The overall postoperative morbidity and hospital stay were comparable between the 2 groups. There were significantly lower incidences of postoperative new-onset diabetes (0% vs 28%, P = .011), acute cellular rejection (6% vs 27%, P = .038), and cytomegalovirus (CMV) antigenemia (0% vs 18%, P = .011) in the IL-2Rab group compared with the steroid group. The blood cholesterol level at 6 months after transplantation was significantly lower in the IL-2Rab group (Median, 4.0 vs 4.4 mmol/L, P = .007). On follow-up, none of the patients in the IL-2Rab group had hepatitis B viral breakthrough or hepatocellular carcinoma (HCC) recurrence, whereas 1 and 3 patients in the steroid group developed these complications, respectively. In conclusion, treatment of liver transplant recipients with IL-2Rab with early withdrawal of steroids and reduction of tacrolimus dosage is associated with lower incidences of postoperative new-onset diabetes, acute cellular rejection, and CMV antigenemia, as well as a lower serum cholesterol level. Further studies and long-term follow-up are required to document their potential benefits on hepatitis B and HCC recurrences. Copyright © 2004 by the American Association for the Study of Liver Diseases.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021en_HK
dc.relation.ispartofLiver Transplantationen_HK
dc.rightsLiver Transplantation. Copyright © John Wiley & Sons, Inc.en_HK
dc.subject.meshAdrenal Cortex Hormones - administration & dosageen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAntibodies, Monoclonal - administration & dosage - therapeutic useen_HK
dc.subject.meshAntigens, Viral - blooden_HK
dc.subject.meshCytomegalovirus - immunologyen_HK
dc.subject.meshDiabetes Mellitus - epidemiology - prevention & controlen_HK
dc.subject.meshDose-Response Relationship, Drugen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshGraft Rejection - epidemiology - prevention & controlen_HK
dc.subject.meshHepatitis B, Chronic - complicationsen_HK
dc.subject.meshHumansen_HK
dc.subject.meshImmunosuppressive Agents - administration & dosage - therapeutic useen_HK
dc.subject.meshIncidenceen_HK
dc.subject.meshInjections, Intravenousen_HK
dc.subject.meshLiver Diseases - surgeryen_HK
dc.subject.meshLiver Transplantation - adverse effects - immunologyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMycophenolic Acid - administration & dosage - analogs & derivativesen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshReceptors, Interleukin-2 - immunologyen_HK
dc.subject.meshRecombinant Fusion Proteinsen_HK
dc.subject.meshTacrolimus - administration & dosageen_HK
dc.titleInterleukin-2 receptor antibody (basiliximab) for immunosuppressive induction therapy after liver transplantation: A protocol with early elimination of steroids and reduction of tacrolimus dosageen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1527-6465&volume=10&issue=6&spage=728&epage=733&date=2004&atitle=Interleukin-2+receptor+antibody+(basiliximab)+for+immunosuppressive+induction+therapy+after+liver+transplantation:+a+protocol+with+early+elimination+of+steroids+and+reduction+of+tacrolimus+dosageen_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailChan, SC: chanlsc@hkucc.hku.hken_HK
dc.identifier.emailNg, IO: iolng@hku.hken_HK
dc.identifier.emailLai, CL: hrmelcl@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityChan, SC=rp01568en_HK
dc.identifier.authorityNg, IO=rp00335en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/lt.20144en_HK
dc.identifier.pmid15162466-
dc.identifier.scopuseid_2-s2.0-2942726371en_HK
dc.identifier.hkuros90471en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-2942726371&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume10en_HK
dc.identifier.issue6en_HK
dc.identifier.spage728en_HK
dc.identifier.epage733en_HK
dc.identifier.isiWOS:000221728300005-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLiu, CL=14519610200en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridChan, SC=7404255575en_HK
dc.identifier.scopusauthoridNg, IO=7102753722en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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