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Titolo:
Use of daclizumab as initial immunosuppression in liver transplant recipients with impaired renal function
Autore:
Emre, S; Gondolesi, G; Polat, K; Ben-Haim, M; Artis, T; Fishbein, TM; Sheiner, PA; Kim-Schluger, L; Schwartz, ME; Miller, CM;
Indirizzi:
Mt Sinai NYU Hlth, Mt Sinai Hosp, Recanati Miller Transplantat Inst, New York, NY 10029 USA Mt Sinai NYU Hlth New York NY USA 10029 ntat Inst, New York, NY 10029 USA
Titolo Testata:
LIVER TRANSPLANTATION
fascicolo: 3, volume: 7, anno: 2001,
pagine: 220 - 225
SICI:
1527-6465(200103)7:3<220:UODAII>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
PREVENT ACUTE REJECTION; HUMANIZED ANTI-TAC; HEPATORENAL-SYNDROME; INDUCTION THERAPY; RECEPTOR ANTIBODY; SINGLE-CENTER; EXPERIENCE; TRIAL; CYCLOSPORINE; EFFICACY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Emre, S Mt Sinai NYU Hlth, Mt Sinai Hosp, Recanati Miller Transplantat Inst, Box 1104,1 Gustave L Levy Pl, New York, NY 10029 USA Mt Sinai NYU Hlth Box 1104,1 Gustave L Levy Pl New York NY USA 10029
Citazione:
S. Emre et al., "Use of daclizumab as initial immunosuppression in liver transplant recipients with impaired renal function", LIVER TRANS, 7(3), 2001, pp. 220-225

Abstract

The addition of daclizumab (a human immunoglobulin G1 monoclonal antibody that blocks interleukin-2 receptors on T lymphocytes) to mycophenolate mofetil (MMF) and steroids is a new option for initial immunosuppression in patients undergoing liver transplantation (LT) with impaired renal function. We evaluated the efficacy and safety of daclizumab in preventing rejection in 25 patients with impaired kidney function undergoing LT. Patients with serum creatinine (Cr) levels greater than 2 mg/dL immediately before LT were administered initial immunosuppression with daclizumab, 1 mg/kg, in addition to MMF, 2 g/d, and methylprednisolone. Tacrolimus mas added after kidney function improved (when Cr levels improved by >25% of initial value). Daclizumab-treated patients mere compared retrospectively with 2 other groups ofpatients who underwent LT with kidney impairment (Cr > 2 mg/dL): 56 patients were administered OKT3 induction, and 48 patients were administered low-dose tacrolimus. The incidence of rejection and infection (bacterial, fungal, and viral), need for preoperative and postoperative dialysis, Cr level immediately post-LT and at 3 months, and graft and patient survival were analyzed. There was no difference among the groups in 3-month Cr levels or theincidence of rejection or fungal or viral infection. The daclizumab group had fewer bacterial infections (n = 13) than the tacrolimus group (n = 28) and significantly fewer than the OKT3 group (n = 58; P =.006). Only 1 patient (4%) in the daclizumab group required dialysis post-LT versus 13 patients in each of the other groups (OKT3, 23.21%; P <.05; tacrolimus, 27%). In the daclizumab group, 2-year patient and graft survival rates were statistically significant compared with the low-dose tacrolimus group (89% and 81% v73% and 69%, respectively; P =.06). There were no side effects related to daclizumab use, and all patients tolerated the drug well. In patients with impaired renal function before LT, daclizumab-based initial immunosuppression can be used safely to reduce the risk for infection and need for dialysis post-LT, with improved longterm graft and patient survival.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/01/20 alle ore 23:06:47