title: Induction therapy with either anti-CD25 monoclonal antibodies or rabbit antithymocyte globulins in liver transplantation for hepatitis C.
abstract: BACKGROUND
  Hepatitis C virus (HCV)-related end-stage liver disease (ESLD) is the leading cause for orthotopic liver transplantation (OLT). The aim of our sequential study was to assess the safety and efficacy of induction therapy using either rabbit antithymocyte globulins (RATG) or anti-CD25 monoclonal antibodies.
  
  
  METHODS
  From January 2000 to January 2003, 31 patients underwent OLT for HCV-related ESLD, and survived more than 1 month post-transplantation. Up to July 2001, induction relied on RATG (Thymoglobulins; Sangstat, Lyon, France) which was given for a median of 5 d, i.e. a total dose of 406 +/- 45 mg (n = 16; group I). Thereafter, induction was based on either basiliximab or dacluzimab (n = 15; group II). Steroids and tacrolimus (from day 1 onwards) were given as maintenance therapy. The primary end-points were at 6 months post-transplantation.
  
  
  RESULTS
  Patient and graft survivals were excellent and similar in both groups. The acute rejection rate was 37.5% in group I and 20% in group II (p = ns). The rates of serious bacterial and fungal infections as well as cytomegalovirus infections were similar in both groups. Even if the overall pattern of post-transplant liver enzymes did not differ between the two groups, the rate of HCV recurrence tended to be higher in group II (80%) compared with group I (56.25%; p = ns) patients. Both induction therapies were clinically and biologically well tolerated.
  
  
  CONCLUSIONS
  RATG induction therapy is as efficient and as safe as induction with anti-CD25 monoclonal antibodies.
authors.affiliation: Department of Nephrology, Dialysis and Multiorgan Transplantation, CHU Toulouse, Rangueil, France.
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar
authors.forename: Jean-Sébastien
authors.initials: JS
authors.lastname: Borde
authors.forename: Karine
authors.initials: K
authors.lastname: Sandres-Saune
authors.forename: Bertrand
authors.initials: B
authors.lastname: Suc
authors.forename: Karl
authors.initials: K
authors.lastname: Barange
authors.forename: Olivier
authors.initials: O
authors.lastname: Cointault
authors.forename: Laurence
authors.initials: L
authors.lastname: Lavayssière
authors.forename: Dominique
authors.initials: D
authors.lastname: Durand
authors.forename: Jacques
authors.initials: J
authors.lastname: Izopet
authors.forename: Lionel
authors.initials: L
authors.lastname: Rostaing
mesh_terms: D000328:Adult; D000818:Animals; D000911:Antibodies, Monoclonal / Q000276:immunology / Q000627:therapeutic use*; D000961:Antilymphocyte Serum / Q000276:immunology / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006085:Graft Survival; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D017093:Liver Failure / Q000601:surgery / Q000821:virology; D016031:Liver Transplantation / Q000276:immunology*; D008297:Male; D011817:Rabbits; D015375:Receptors, Interleukin-2 / Q000276:immunology*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D015375:Receptors, Interleukin-2