Initial experience of dual maintenance immunosuppression with steroid withdrawal in vascular composite tissue allotransplantation

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
J R Diaz-SisoStefan G Tullius

Abstract

Current immunosuppression in VCA is largely based on the experience in solid organ transplantation. It remains unclear if steroids can be reduced safely in VCA recipients. We report on five VCA recipients who were weaned off maintenance steroids after a median of 2 months (mean: 4.8 months, range 2-12 months). Patients were kept subsequently on a low dose, dual maintenance consisting of tacrolimus and mycophenolate mofetil/mycophenloic acid with a mean follow-up of 43.6 months (median = 40 months, range 34-64 months). Early and late acute rejections responded well to temporarily augmented maintenance, topical immunosuppression, and/or steroid bolus treatment. One late steroid-resistant acute rejection required treatment with thymoglobulin. All patients have been gradually weaned off steroids subsequent to the treatment of acute rejections. Low levels of tacrolimus (<5 ng/mL) appeared as a risk for acute rejections. Although further experience and a cautious approach are warranted, dual-steroid free maintenance immunosuppression appears feasible in a series of five VCA recipients.

References

Oct 24, 2002·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Leslie W Miller
Jul 5, 2003·Lancet·David M LeviPhillip Ruiz
Apr 26, 2005·Transplantation Proceedings·M J HanawayE S Woodle
May 10, 2005·Transplantation·Marco LanzettaXinying Zhang
Apr 14, 2007·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·R CiprianiA D Pinna
May 1, 2008·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·L C CendalesL Racusen
Aug 30, 2008·Lancet·Shuzhong GuoHuiyuan Li
Aug 30, 2008·Transplantation·Palmina PetruzzoPedro Cavadas
Sep 3, 2008·The Journal of Hand Surgery·Warren C BreidenbachVijay S Gorantla
Mar 31, 2009·Transplantation Proceedings·G BrandacherS Schneeberger
Sep 1, 2009·Transplantation Proceedings·M A CastelE Roig
Nov 17, 2009·Plastic and Reconstructive Surgery·Bohdan PomahacJulian J Pribaz
Jan 1, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J V UnadkatW P Andrew Lee
Feb 4, 2010·Plastic and Reconstructive Surgery·David Mathes
Nov 6, 2010·Transplantation·Palmina PetruzzoChristian Dumontier
Nov 26, 2010·Transplantation Proceedings·T HautzS Schneeberger
Jan 11, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·B PomahacS G Tullius
Jan 29, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·L LantieriP Grimbert
Mar 31, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P PetruzzoE Morelon
Apr 28, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P C CavadasL Alfaro
Jun 8, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A P SaavedraB Pomahac
Jul 21, 2011·Annals of Surgery·Juan P BarretVicenç Martínez-Ibáñez
Aug 30, 2011·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·E M BuenoB Pomahac
Sep 20, 2011·Transplant International : Official Journal of the European Society for Organ Transplantation·Simon R Knight, Peter J Morris
Nov 19, 2011·Plastic and Reconstructive Surgery·Maria Siemionow, Can Ozturk
Dec 15, 2011·Transplantation·Palmina PetruzzoJean-Michel Dubernard
Dec 30, 2011·The New England Journal of Medicine·Bohdan PomahacStefan G Tullius
Feb 14, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·C L KaufmanM R Marvin
Feb 22, 2012·Clinical Journal of the American Society of Nephrology : CJASN·Joshua J Augustine, Donald E Hricik
May 12, 2012·Plastic and Reconstructive Surgery·Bohdan PomahacElof Eriksson
Sep 25, 2012·Annals of Surgery·Stefan SchneebergerW P Andrew Lee
Oct 19, 2012·Plastic and Reconstructive Surgery·Amir H DorafsharEduardo D Rodriguez
Jan 3, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·B M KnollF M Marty
Mar 5, 2013·International Immunopharmacology·Marion FaulhaberChristoph L Bara

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Citations

Aug 21, 2015·Expert Review of Clinical Immunology·Madeline FryerGerald Brandacher
Aug 13, 2015·Transplant International : Official Journal of the European Society for Organ Transplantation·Maximilian KueckelhausStefan G Tullius
May 14, 2016·Journal of Surgical Oncology·J Rodrigo Diaz-SisoEduardo D Rodriguez
Aug 29, 2016·Lancet·Laurent LantieriMikael Hivelin
Apr 1, 2017·Journal of Materials Science. Materials in Medicine·Jaimie T ShoresGerald Brandacher
Dec 28, 2016·Plastic and Reconstructive Surgery·Mario A AycartMegan L Oser
Feb 9, 2018·Transplant International : Official Journal of the European Society for Organ Transplantation·Sotirios TasigiorgosBohdan Pomahac
Mar 1, 2018·Annals of Surgery·William J RifkinEduardo D Rodriguez
Aug 31, 2018·Microsurgery·Sebastian FischerBohdan Pomahac
Mar 5, 2019·Transplant International : Official Journal of the European Society for Organ Transplantation·Zhi Yang NgCurtis L Cetrulo
Apr 19, 2019·JAMA Facial Plastic Surgery·Valentin HaugBohdan Pomahac
May 30, 2019·The New England Journal of Medicine·Sotirios TasigiorgosBohdan Pomahac
May 1, 2020·Journal of Burn Care & Research : Official Publication of the American Burn Association·Amon-Ra GamaCurtis L Cetrulo
Apr 30, 2020·Transplant International : Official Journal of the European Society for Organ Transplantation·Tomohisa MatsunagaStefan G Tullius
Aug 1, 2018·Hand : Official Journal of the American Association for Hand Surgery·Shaun D MendenhallL Scott Levin
Mar 30, 2020·Plastic and Reconstructive Surgery·Alexandre G LellouchCurtis L Cetrulo
Jan 11, 2016·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·T J BorgesL V Riella
Jun 22, 2016·Transplantation·Sarah-Jayne Edmondson, Fadi Issa
Mar 8, 2019·Cellular & Molecular Immunology·Jasper IskeStefan G Tullius
Oct 10, 2018·Scientific Reports·Branislav KollarLeonardo V Riella
Oct 13, 2020·Frontiers in Immunology·Dimitrios GiannisLinda C Cendales
Aug 12, 2018·Journal of Surgical Oncology·Branislav KollarBohdan Pomahac
Jan 1, 2021·Seminars in Plastic Surgery·Tom ShokriYadranko Ducic
Mar 2, 2018·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·Branislav Kollar, Bohdan Pomahac
Sep 26, 2020·The Journal of Surgical Research·William J RifkinEduardo D Rodriguez
Aug 31, 2021·Frontiers in Immunology·Dimitrios Moris, Linda C Cendales
Oct 21, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Kelly WaltonBrian C Betts

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