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Conference Paper: Interleukin-2 receptor antibody for immunosuppressive induction therapy after liver transplantation in patients with chronic hepatitis B infection

TitleInterleukin-2 receptor antibody for immunosuppressive induction therapy after liver transplantation in patients with chronic hepatitis B infection
Authors
Issue Date2003
PublisherBlackwell Munksgaard. The Journal's web site is located at http://www.blackwellpublishing.com/journals/AJT
Citation
The American Transplant Congress 2003, Washington DC, USA, 30 May - 4 June 2003. In American Journal of Transplantation, 2003, v. 3 n. Suppl. 5, p. 375, abstract no. 871 How to Cite?
AbstractBackground We hypothesize that the use of interleukin-2 (IL-2) receptor antibody in the induction therapy with early elimination of steroid is beneficial to patients with chronic hepatitis B disease undergoing liver transplantation. Patients and Methods We prospectively evaluate a series of 24 patients with chronic hepatitis B infection who underwent live-donor (n = 14) or cadaveric (n = 10) liver transplantation. Six patients had co-existing hepatocellular carcinoma. IL-2 receptor antibody (basiliximab 20mg, n = 7; or daclizumab 1mg/kg, n = 17) was prescribed within 6 hours of graft reperfusion and postoperative day 4 (IL-2 group). Methylprednisolone injection was given intraoperatively (1g) and on postoperative day 1 (500mg). Postoperative immunosuppression was maintained with oral tacrolimus (trough level of 5 to 10ng/ ml) and mycophenolate mofetil (750mg twice daily) without the use of steroid. Oral lamividine 100mg daily was used for hepatitis B prophylaxis. The operative outcomes were compared with 32 patients who received standard immunosuppressive regimen consisting of tacrolimus and corticosteroid (steroid group). Results There was a trend towards lower incidences of postoperative hypertension and diabetes in the IL-2 group compared with the steroid group (0% vs 16%, p = 0.072; 6% vs 31%, p = 0.065, respectively). The median postoperative hospital stay was 15 days in the IL-2 group, and that of the steroid group of patients was 21 days (p = 0.123). With a median followup of 5.8 months, 4 (17%) patients in the IL-2 group had acute cellular rejection and required steroid treatment. The incidence was not different from that of the steroid group (28%, p = 0.358). None of the patients in the IL-2 group had hepatitis B viral breakthrough, while one patient in the steroid group had the complication and required treatment with adefovir. Conclusions Treatment of liver transplant recipients who had underlying chronic hepatitis B with IL-2 receptor antibody and early withdrawal of steroid is associated with a trend towards lower incidences of postoperative diabetes and hypertension, without increase in the incidence of acute cellular rejection. Longterm follow-up is required to document the potential benefits on hepatitis B and liver tumor recurrence.
Persistent Identifierhttp://hdl.handle.net/10722/78650
ISSN
2015 Impact Factor: 5.669
2015 SCImago Journal Rankings: 2.792

 

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, IOLen_HK
dc.contributor.authorLai, CLen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T07:45:14Z-
dc.date.available2010-09-06T07:45:14Z-
dc.date.issued2003en_HK
dc.identifier.citationThe American Transplant Congress 2003, Washington DC, USA, 30 May - 4 June 2003. In American Journal of Transplantation, 2003, v. 3 n. Suppl. 5, p. 375, abstract no. 871en_HK
dc.identifier.issn1600-6135en_HK
dc.identifier.urihttp://hdl.handle.net/10722/78650-
dc.description.abstractBackground We hypothesize that the use of interleukin-2 (IL-2) receptor antibody in the induction therapy with early elimination of steroid is beneficial to patients with chronic hepatitis B disease undergoing liver transplantation. Patients and Methods We prospectively evaluate a series of 24 patients with chronic hepatitis B infection who underwent live-donor (n = 14) or cadaveric (n = 10) liver transplantation. Six patients had co-existing hepatocellular carcinoma. IL-2 receptor antibody (basiliximab 20mg, n = 7; or daclizumab 1mg/kg, n = 17) was prescribed within 6 hours of graft reperfusion and postoperative day 4 (IL-2 group). Methylprednisolone injection was given intraoperatively (1g) and on postoperative day 1 (500mg). Postoperative immunosuppression was maintained with oral tacrolimus (trough level of 5 to 10ng/ ml) and mycophenolate mofetil (750mg twice daily) without the use of steroid. Oral lamividine 100mg daily was used for hepatitis B prophylaxis. The operative outcomes were compared with 32 patients who received standard immunosuppressive regimen consisting of tacrolimus and corticosteroid (steroid group). Results There was a trend towards lower incidences of postoperative hypertension and diabetes in the IL-2 group compared with the steroid group (0% vs 16%, p = 0.072; 6% vs 31%, p = 0.065, respectively). The median postoperative hospital stay was 15 days in the IL-2 group, and that of the steroid group of patients was 21 days (p = 0.123). With a median followup of 5.8 months, 4 (17%) patients in the IL-2 group had acute cellular rejection and required steroid treatment. The incidence was not different from that of the steroid group (28%, p = 0.358). None of the patients in the IL-2 group had hepatitis B viral breakthrough, while one patient in the steroid group had the complication and required treatment with adefovir. Conclusions Treatment of liver transplant recipients who had underlying chronic hepatitis B with IL-2 receptor antibody and early withdrawal of steroid is associated with a trend towards lower incidences of postoperative diabetes and hypertension, without increase in the incidence of acute cellular rejection. Longterm follow-up is required to document the potential benefits on hepatitis B and liver tumor recurrence.-
dc.languageengen_HK
dc.publisherBlackwell Munksgaard. The Journal's web site is located at http://www.blackwellpublishing.com/journals/AJTen_HK
dc.relation.ispartofAmerican Journal of Transplantationen_HK
dc.rightsThe definitive version is available at www.blackwell-synergy.com-
dc.titleInterleukin-2 receptor antibody for immunosuppressive induction therapy after liver transplantation in patients with chronic hepatitis B infectionen_HK
dc.typeConference_Paperen_HK
dc.identifier.emailLiu, CL: clliu@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailChan, SC: seechingchan@gmail.comen_HK
dc.identifier.emailNg, IOL: iolng@hkucc.hku.hken_HK
dc.identifier.emailLai, CL: hrmelcl@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hk-
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityChan, SC=rp01568en_HK
dc.identifier.authorityNg, IOL=rp00335en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1034/j.1600-6143.3.s5.015b.x-
dc.identifier.hkuros83359en_HK
dc.identifier.hkuros78626-
dc.identifier.volume3-
dc.identifier.issueSuppl. 5-
dc.identifier.spage375, abstract no. 871-
dc.identifier.epage375, abstract no. 871-
dc.publisher.placeDenmark-
dc.description.otherThe American Transplant Congress 2003, Washington DC, USA, 30 May - 4 June 2003. In American Journal of Transplantation, 2003, v. 3 n. Suppl. 5, p. 375, abstract no. 871-

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