title: Use of tacrolimus in rescue therapy of acute and chronic rejection in liver transplantation.
abstract: OBJECTIVE
  To study the indications and results of tacrolimus as rescue therapy for acute cellular or chronic rejection in liver transplantation.
  
  
  METHODS
  Eighteen liver transplant recipients who underwent rescue therapy with tacrolimus between March 1995 and August 1999 were retrospectively studied. The treatment indication, patients, and graft situation were recorded as of October 31st, 1999. The response to tacrolimus was defined as patient survival with a functional graft and histological reversal of acute cellular, or for chronic rejection, bilirubin serum levels decreasing to up to twice the upper normal limit.
  
  
  RESULTS
  Fourteen cases (77.8%) presented a good response. The response rate for the different indications was: (1) acute cellular + sepsis - 0/1 case; (2) recurrent acute cellular - 1/1 case; (3) OKT3-resistant acute cellular - 2/2 cases; (4) steroid-resistant acute cellular + active viral infection - 3/3 cases; (5) chronic rejection - 8/11 cases (72.7% response rate). The 4 patients who did not respond died.
  
  
  CONCLUSIONS
  Tacrolimus rescue therapy was successful in most cases of acute cellular and chronic rejection in liver transplantation.
authors.affiliation: Department of Surgery, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Fabricio Ferreira
authors.initials: FF
authors.lastname: Coelho
authors.forename: Rafael Ferreira
authors.initials: RF
authors.lastname: Coelho
authors.forename: Paulo Celso Bosco
authors.initials: PC
authors.lastname: Massarollo
authors.forename: Sérgio
authors.initials: S
authors.lastname: Mies
mesh_terms: D000293:Adolescent; D000328:Adult; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000188:drug therapy*; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016031:Liver Transplantation; D008875:Middle Aged; D012189:Retrospective Studies; D016879:Salvage Therapy; D016559:Tacrolimus / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus