FK506 conversion therapy in pediatric liver transplantation

Transplantation
H EgawaL Lawrence

Abstract

The safety and efficacy of conversion to FK506 after failing immunosuppression with cyclosporine was prospectively evaluated in 31 pediatric liver transplant recipients between April 1991 and March 1993. The patients, who ranged in age from 40 days to 14 years, accounted for 28 primary transplantations and 3 retransplantations. The initial immunosuppression regimen consisted of cyclosporine in combination with prednisone. The indications for conversion were acute or chronic rejection refractory to OKT3, Minnesota antilymphocyte globulin, or steroids (13 patients); hypertension (8 patients); inability to reach a therapeutic level of cyclosporine (6 patients); hirsutism (3 patients); and growth retardation (1 patient). After an average follow-up of 10 months (range, 2 to 25 months), 27 (87%) of the patients are alive and have functioning grafts. Of the 13 patients who were converted for refractory rejection, 9 are alive. Six of these 9 patients experienced a complete biochemical reversal of the rejection process within 3 months of conversion; 2 had a partial response to conversion, and 1 patient failed but underwent successful retransplantation. Three of the 4 patients who died did so without showing any improvement. The remainin...Continue Reading

Citations

Sep 9, 1999·Liver Transplantation and Surgery : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·O A AchilleosD A Kelly
Jan 1, 1996·Transplant International : Official Journal of the European Society for Organ Transplantation·S JonasP Neuhaus
Nov 19, 2003·Indian Journal of Pediatrics·Deirdre Kelly, Anupam Sibal
Jun 24, 1998·Transplantation Proceedings·F NavarroJ Domergue
May 1, 1996·Journal of Hepatology·P F Whitington
Aug 26, 1998·Journal of Cardiothoracic and Vascular Anesthesia·L M MontenegroP J Davis
Jan 27, 1998·Journal of Pediatric Gastroenterology and Nutrition·S V McDiarmid
Aug 14, 1998·Journal of Pediatric Gastroenterology and Nutrition·D A Kelly
Mar 27, 1997·Transplantation·T KiuchiK Tanaka
Jul 27, 1997·Transplantation·T V CacciarelliS K So
Feb 28, 2001·Paediatric Drugs·I D van Mourik, D A Kelly
Jan 17, 2003·Paediatric Drugs·Dominique DebrayChristophe Chardot
Nov 5, 1999·Liver Transplantation and Surgery : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·A Klein
Aug 26, 1998·Therapeutic Drug Monitoring·M MorenoP Jara
Mar 10, 2001·Clinics in Liver Disease·S V McDiarmid
Aug 10, 2000·Pediatric Transplantation·V FurlanA M Taburet

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