High dose rabbit antithymocyte globulin induction in living related liver transplantation.
OBJECTIVE
Induction with rabbit antithymocyte globulin (RATG) has been reported to be effective in cadaveric liver transplantation. The aim of this study was to compare two immunosuppressive protocols in adult living-related liver transplantation (LRLT).


METHODS
From May 2001 through May 2003, 34 LRLT were performed. The first 17 patients (group 1) were treated with tacrolimus (TAC) and steroids. The next 17 patients (group 2) were treated with a steroid-sparing protocol using RATG.


RESULTS
The one-year patient and graft survival was respectively 76.5% and 64.7% for group 1 and 88.2 and 76.5% for group 2 (p = 0.037 and p = NS, respectively). Incidence of acute cellular rejection was 41.2% in group 1 compared to 47% in group 2 (p = NS). Mean daily TAC dose at 6 months was 6.5 +/- 1.1 mg/day in group 1 and 3.2 +/- 0.9 mg/day in group 2 (p < 0.001). In group 1, 41.1% experienced CMV infection compared to 11.7% in group 2 (p = NS).


CONCLUSIONS
These results suggest that this approach of RATG induction followed by postoperative, steroid-free, and low-dose TAC is safe and provides for adequate immunosuppression and similar outcome when compared to controls treated with standard TAC and steroid immunosuppression.
Masetti
Michele
M
Liver and Multivisceral Transplant Center, University of Modena and Reggio Emilia, #71 via del Pozzo, 41100 Modena, Italy.
Montalti
Roberto
R
Arpinati
Mario
M
Di Benedetto
Fabrizio
F
Miller
Charles M
CM
Zagnoli
Alessandra
A
De Ruvo
Nicola
N
Guerrini
Gian Piero
GP
Romano
Antonio
A
Rondelli
Damiano
D
Chirumbolo
Gabriella
G
Rompianesi
Gianluca
G
Pinna
Antonio D
AD
Gerunda
Giorgio E
GE
D000328:Adult; D000818:Animals; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016031:Liver Transplantation; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D011817:Rabbits; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000166:cytology; D016559:Tacrolimus / Q000627:therapeutic use; D016896:Treatment Outcome
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016559:Tacrolimus