21 May 2009
Immunosuppression with daclizumab in liver transplant recipients with impaired kidney function: A single centre experience
M Post, J Raszeja-Wyszomirska, K Jarosz, M Wasilewicz, M Mydłowska, P Milkiewicz, M WójcickiAnn Transplant 2009; 14(1): 30-30 :: ID: 880306
Abstract
Background: Nephrotoxicity of calcineurine inhibitors (CI) may exert a detrimental effect, particularly in liver transplant (OLTx) recipients with an already impaired kidney function. Immunosuppression with daclizumab permits delayed introduction of CI, and may be preferred in patients with kidney dysfunction. Aim: Retrospective analysis of our experience in immunosuppression with daclizumab in patients with impaired kidney function transplanted in our centre.
Material/Methods: One hundred and sixty eight patients were analyzed. Subjects who died within 10 days after OLTx due to surgical complications were excluded. Serum creatinine (Cr) >1.5 mg/dl was an indication for a protocol with daclizumab (50 mg i.v., day 0 and day 4), mycophenolate mofetil (MMF) 500 mg twice daily i.v./orally and prednisolone tapering doses from day 0 after OLTx. CI were introduced on day 4-15 after OLTx. Patients with Cr below 1.5mg/dl received immunosuppression with CI+MMF+steroids or CI+steroids. Data are presented as mean ±SD. Statistical analysis was done with Anova and paired t-test. P values <0.05 were considered significant.
Results: Fourteen patients fulfilled criterion for immunosuppression with daclizumab. Their Cr and creatinine clearance (CrCl) at OLTx were 2.85±1.22 mg/dl and 19±11 ml/min respectively. In remaining 154 patients Cr and CrCl were 0.88±0.3mg/dl and 107±82ml/min. respectively. At discharge, in daclizumab group Cr and CrCl were 0.97±0.45 mg/dl and 86±34 ml/min. (p<0.0001 for both, when compared to values at OLTx). Both Cr and CrCl at discharge were not statistically different when compared to Cr and CrCl in patients transplanted with the normal kidney function. The incidence of acute rejection was 14% in daclizumab group and 18% in the others (p=NS). Conclusions: Immunosuppression with daclizumab and delayed introduction of CI is safe and does not increase the risk of acute rejection thus offers an excellent therapeutic option in patients transplanted with impaired kidney function.
Keywords: Liver Transplantation, clinical outcome
In Press
18 Mar 2024 : Original article
Does Antibiotic Use Increase the Risk of Post-Transplantation Diabetes Mellitus? A Retrospective Study of R...Ann Transplant In Press; DOI: 10.12659/AOT.943282
20 Mar 2024 : Original article
Transplant Nephrectomy: A Comparative Study of Timing and Techniques in a Single InstitutionAnn Transplant In Press; DOI: 10.12659/AOT.942252
28 Mar 2024 : Original article
Association Between FEV₁ Decline Rate and Mortality in Long-Term Follow-Up of a 21-Patient Pilot Clinical T...Ann Transplant In Press; DOI: 10.12659/AOT.942823
02 Apr 2024 : Original article
Liver Transplantation from Brain-Dead Donors with Hepatitis B or C in South Korea: A 2014-2020 Korean Organ...Ann Transplant In Press; DOI: 10.12659/AOT.943588
Most Viewed Current Articles
05 Apr 2022 : Original article
Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver TransplantationDOI :10.12659/AOT.935604
Ann Transplant 2022; 27:e935604
12 Jan 2022 : Original article
Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...DOI :10.12659/AOT.934738
Ann Transplant 2022; 27:e934738
22 Nov 2022 : Original article
Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...DOI :10.12659/AOT.937988
Ann Transplant 2022; 27:e937988
15 Mar 2022 : Case report
Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...DOI :10.12659/AOT.935860
Ann Transplant 2022; 27:e935860