title: Steroid-free liver transplantation in children.
abstract: Although corticosteroids have been part of immunosuppressive regimens since the early days of transplantation, steroid avoidance could be beneficial. To test this hypothesis in paediatric liver transplantation, we compared liver-transplantation under steroid-free immunosuppression in 20 children, who received combined tacrolimus and basiliximab, with that under tacrolimus and steroids in 20 matched historical recipients as a historical control group. 12-month rejection-free survival was 75% in the tacrolimus-basiliximab group compared with 50% in the steroid group (p=0.05). Growth in the first year after transplantation was significantly better in the tacrolimus-basiliximab group than in the steroid group. Steroid avoidance was, therefore, not harmful to our patients, and combining tacrolimus with basiliximab as a steroid substitution seems a safe alternative to tacrolimus and steroid immunosuppression.
authors.affiliation: Paediatric Liver Transplant Program, Université Catholique de Louvain, Saint-Luc University Clinics, 10 Hippocrate Avenue, 1200, Brussels, Belgium. reding@chex.ucl.ac.be
authors.forename: Raymond
authors.initials: R
authors.lastname: Reding
authors.forename: Jérémie
authors.initials: J
authors.lastname: Gras
authors.forename: Etienne
authors.initials: E
authors.lastname: Sokal
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Otte
authors.forename: Hugh F S
authors.initials: HF
authors.lastname: Davies
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000627:therapeutic use; D000367:Age Factors; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D000077552:Basiliximab; D002648:Child; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects / Q000502:physiology; D006128:Growth / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007108:Immune Tolerance; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000276:immunology / Q000379:methods*; D010865:Pilot Projects; D011184:Postoperative Period; D011993:Recombinant Fusion Proteins; D016559:Tacrolimus / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab; D016559:Tacrolimus