title: Steroid minimization immunosuppression protocol using basiliximab in adult living donor liver transplantation for hepatitis C virus-related cirrhosis.
abstract: OBJECTIVE
  Recent randomized trials have failed to prove the benefit of steroid-free immunosuppression in liver transplantation for hepatitis C virus (HCV)-related cirrhosis. Furthermore, there is a lack of data on the use of basiliximab in living donor liver transplantation (LDLT). This pilot study evaluated the safety and efficacy of a steroid minimization protocol using basiliximab compared with standard immunosuppression.
  
  
  METHODS
  A single center, prospective cohort analysis was conducted to compare two immunosuppression regimens in adult recipients who underwent LDLT for HCV since 2004: calcineurin inhibitor/mizoribine/basiliximab (the St- group) and calcineurin inhibitor/mizoribine/steroid (the St+ group). Study end-points were rejection rates, recurrent HCV, patient survival and other adverse events up to 2 years after transplantation.
  
  
  RESULTS
  A total of 27 consecutive patients were enrolled. Transplantation characteristics were similar between the two groups (14 St- and 13 St+) except ABO incompatible cases being more common in the St+ group. Rejection rates, recurrent HCV, patient survival, fibrosis stage and new-onset diabetes mellitus at 2 years were comparable between the two groups. ABO incompatibility did not affect short- and long-term outcomes. Nine St- and seven St+ recipients underwent interferon and ribavirin therapy for recurrent HCV, with a sustained virological response rate of 33% and 29%, respectively.
  
  
  CONCLUSIONS
  A steroid minimization protocol with basiliximab in adult LDLT for HCV is safe and affords equivalent rejection rates compared with standard immunosuppression. However, no significant differences are observed with respect to recurrent HCV, patient survival and metabolic complications.
authors.affiliation: Department of Surgery, Keio University School of Medicine.
authors.forename: Taizo
authors.initials: T
authors.lastname: Hibi
authors.affiliation: Department of Surgery, Keio University School of Medicine.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shinoda
authors.affiliation: Department of Surgery, Keio University School of Medicine.
authors.forename: Osamu
authors.initials: O
authors.lastname: Itano
authors.affiliation: Department of Surgery, Keio University School of Medicine.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Obara
authors.affiliation: Department of Surgery, Keio University School of Medicine.
authors.forename: Minoru
authors.initials: M
authors.lastname: Kitago
authors.affiliation: Department of Surgery, Keio University School of Medicine.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Department of Surgery, Keio University School of Medicine.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yagi
authors.affiliation: Department of Surgery, Keio University School of Medicine.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Surgery, Keio University School of Medicine.
authors.forename: Ken
authors.initials: K
authors.lastname: Hoshino
authors.affiliation: Department of Surgery, Keio University School of Medicine.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Fujino
authors.affiliation: Department of Surgery, Keio University School of Medicine.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kuroda
authors.affiliation: Division of Digestive Surgery and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Kawachi
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Tanabe
authors.affiliation: Division of Digestive Surgery and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center.
authors.forename: Motohide
authors.initials: M
authors.lastname: Shimazu
authors.affiliation: Department of Surgery, Keio University School of Medicine.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
keywords: basiliximab; hepatitis C virus; immunosuppression; liver transplantation; living donors; steroids