Steroid-free liver transplantation in children.
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.
Reding
Raymond
R
Paediatric Liver Transplant Program, Université Catholique de Louvain, Saint-Luc University Clinics, 10 Hippocrate Avenue, 1200, Brussels, Belgium. reding@chex.ucl.ac.be
Gras
Jérémie
J
Sokal
Etienne
E
Otte
Jean-Bernard
JB
Davies
Hugh F S
HF
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*
D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab; D016559:Tacrolimus