Reasons why some children receiving tacrolimus therapy require steroids more than 5 years post liver transplantation

Pediatric Transplantation
A JainJ Reyes

Abstract

Tacrolimus is a potent immunosuppressive agent and has been used in liver transplantation (LTx) for nearly a decade. More than 70% of children can be maintained on tacrolimus monotherapy, without steroids, by the end of 1 yr post-Tx. This freedom from steroids does not appear to change significantly in subsequent years. The use of steroids has obvious metabolic and cosmetic disadvantages, besides affecting linear growth in children. The present study identifies why some children still require steroid therapy after successful LTx. One hundred and sixty-six consecutive pediatric patients who had undergone primary LTx between October 1989 and December 1992, were included in this study. Follow-up ranged from 6 to 9 yr (mean 7.5 +/- 0.8 yr). One hundred and forty-one children were alive in November 1998 and these patients constituted the study group. Their current rate of prednisone use, reason for prednisone use, and prednisone dose were examined retrospectively. Of the 141 patients, 139 (98.5%) had stopped taking steroids at some time-point after LTx. Thirteen patients (9%) were off immunosuppression altogether (group I), 97 were undergoing tacrolimus monotherapy (group II), and the remaining 31 were receiving therapy with steroid...Continue Reading

References

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Citations

Feb 5, 2002·Current Gastroenterology Reports·Debora Kogan-LibermanBenjamin L Shneider
Mar 30, 2002·Transplantation·Ashok JainJorge Reyes
May 25, 2005·Pediatric Transplantation·Fabienne DobbelsSabina De Geest
Aug 2, 2005·Journal of Pediatric Gastroenterology and Nutrition·Abdulrahman Al-HussainiAnil Dhawan
Jan 24, 2008·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·V NgA Fecteau
Dec 11, 2008·Pediatric Transplantation·Yumirle P TurmelleRoss W Shepherd
Dec 16, 2004·Pediatric Transplantation·Raymond RedingRichard Fine

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