title: Induction immunosuppressive therapy is associated with a low rejection rate after liver transplantation.
abstract: Despite advances in immunosuppression, allograft rejection occurs frequently after liver transplantation. The use of induction therapy with cytolytic antibodies may decrease the frequency of rejection in liver transplant recipients, but may also increase the rate of cytomegalovirus (CMV) infection. It has been our center's strategy to use induction therapy in our liver transplant recipients. To determine the outcome of our strategy, we retrospectively reviewed all liver transplants performed in the first 5 yr of our liver transplant program. The frequency of acute rejection in the first year after liver transplantation was only 34% in patients who received induction therapy. The type of induction therapy antibody did not affect the rejection rate. Clinically significant CMV infection (requiring treatment) occurred in 22% of patients. These results suggest that use of induction therapy with cytolytic antibodies does not lead to a high incidence of CMV infection and decreases the incidence of rejection after liver transplantation.
authors.affiliation: Department of Surgery, University of Washington School of Medicine, Seattle, USA. jpmcvicar@ucdavis.edu
authors.forename: J P
authors.initials: JP
authors.lastname: McVicar
authors.forename: K V
authors.initials: KV
authors.lastname: Kowdley
authors.forename: M J
authors.initials: MJ
authors.lastname: Emond
authors.forename: D
authors.initials: D
authors.lastname: Barr
authors.forename: C L
authors.initials: CL
authors.lastname: Marsh
authors.forename: R L
authors.initials: RL
authors.lastname: Carithers
authors.forename: J D
authors.initials: JD
authors.lastname: Perkins
mesh_terms: D000208:Acute Disease; D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000961:Antilymphocyte Serum / Q000008:administration & dosage / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D001706:Biopsy; D016572:Cyclosporine / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006084:Graft Rejection / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015994:Incidence; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D016853:Muromonab-CD3 / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000276:immunology; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D000961:Antilymphocyte Serum; D000998:Antiviral Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016853:Muromonab-CD3; D016572:Cyclosporine; D001379:Azathioprine; D000212:Acyclovir; D008775:Methylprednisolone