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Steroid-free immunosuppression after liver transplantation does not increase the risk of graft fibrosis.

Abstract：

BACKGROUND:Steroid-free immunosuppression after liver transplantation (OLT) is effective and safe in the short and mid terms. However, research has shown a higher risk for late fibrosis among pediatric liver transplant recipients who have steroids withdrawn. Our aim was to test this hypothesis in the adult population. PATIENTS AND METHODS:The study involved 27 adults, 14 of whom were on a regimen of cyclosporine, azathioprine, and steroid (group A) and 13 cyclosporine and azathioprine steroid-free immunosuppression (group B). The main end point of the study was liver graft histology in the late stage after OLT, with emphasis on the evolution of fibrosis, which was scored according to Ishak. The secondary end points were patient and graft survivals, liver and kidney functions, rejection rates, infections, and tumors, as well as the incidences of cardiovascular and metabolic complications. RESULTS:After a mean follow-up of 89.3 +/- 21 months, the mean fibrosis scores did not differ between the 2 groups (2.2 +/- 1.5 vs 1.9 +/- 1.2; P = NS). One group A patient developed a severe acute rejection episode. The 7-year patient and graft survivals, as well as liver and kidney functions, incidence of infections, and cardiovascular and metabolic complications were comparable. Patients receiving steroids showed a trend toward an higher rate of de novo malignancies. CONCLUSION:Steroid-free immunosuppression did not increase the risk of graft fibrosis in the long term.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Manzia TM,Toti L,Angelico R,Di Cocco P,Orlando G,Tisone G

doi

10.1016/j.transproceed.2010.03.118

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

1237-9

issue

4

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(10)00457-4

journal_volume

42

pub_type

杂志文章

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