title: Interleukin-2 receptor antagonists in liver transplantation: a meta-analysis of randomized trials.
abstract: BACKGROUND
  The efficacy and safety of interleukin-2 receptor antagonist (IL-2Ra) induction therapy in liver transplantation has not reached a final conclusion. This study sought to explore the effects of IL-2Ra therapy on occurrence of biopsy-proven acute rejection (BPAR), risk of infection, and other adverse events by using meta-analysis.
  
  
  METHODS
  We reviewed randomized trials assessing IL-2Ra therapeutic effects in liver transplantation. We synthesized published data using the random-effects and fixed-effect models, expressing results as relative risk (RR) with 95% confidence intervals (CI).
  
  
  RESULTS
  Among 12 trials including 3,251 participants, IL-2Ra significantly reduced the incidence of BPAR (RR 0.82, 95% CI 0.68-0.99) and de novo diabetes mellitus (RR 0.75, 95% CI 0.62-0.91) within 1 year. Subgroup analysis showed only daclizumab but not basiliximab treatment to significantly benefit BPAR and de novo diabetes mellitus. There were no significant differences in the graft losses (RR 1.05, 95% CI 0.85-1.31), mortality rates (RR 0.89, 95% CI 0.70-1.13), overall incidences of infection (RR 0.95, 95% CI 0.87-1.04), incidences of cytomegalovirus infections (RR 0.96, 95% CI 0.65-1.44), risks of malignancies (RR 1.06, 95% CI 0.56-2.01), or de novo hypertension (RR 0.90, 95% CI 0.79-1.03) or and renal insufficiency (RR 0.81, 95% CI 0.56-1.17, P = .26) within 1 year.
  
  
  CONCLUSIONS
  The IL-2Ra daclizumab, but not basiliximab, shows significant benefit to reduce acute rejection episodes and de novo diabetes mellitus within 1 year among patients undergoing liver transplantation. There was no evidence of an increased risk of infection or other side effects.
authors.affiliation: Department of General Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
authors.forename: X F
authors.initials: XF
authors.lastname: Wang
authors.forename: J D
authors.initials: JD
authors.lastname: Li
authors.forename: Y
authors.initials: Y
authors.lastname: Peng
authors.forename: Y
authors.initials: Y
authors.lastname: Dai
authors.forename: G
authors.initials: G
authors.lastname: Shi
authors.forename: W
authors.initials: W
authors.lastname: Xu
mesh_terms: D006801:Humans; D053645:Interleukin-2 Receptor alpha Subunit / Q000627:therapeutic use*; D016031:Liver Transplantation; D016032:Randomized Controlled Trials as Topic
chemical_list: D053645:Interleukin-2 Receptor alpha Subunit