BACKGROUND:Induction immunosuppression with anti-thymocyte globulin (ATG) provides potential benefits after liver transplantation (LT). However, its use in patients with LT and hepatitis C (HCV) is controversial. AIM: To evaluate the 1- and 2-year patient survival and HCV recurrence rate in patients receiving ATG during the induction phase of immunosuppression (IPI) after LT. METHODS: A total of 49 patients undergoing their first LT for HCV were randomized to receive ATG during IPI. Patient survival and HCV recurrence were determined at 1 and 2 years. The frequency of acute cellular rejection (ACR), infections, and neoplasms was also evaluated. RESULTS:Twenty-six patients were randomized to receive ATG (Arm-1) and 23 to standard induction therapy (Arm-2). Those given ATG had lower HCV recurrence (26.9 vs 73.9 %, p = 0.001). The 1- and 2-year patient survival rates were similar for both arms (p = 0.33). Infections occurred in 46.1 % subjects in Arm-1 and 34.7 % in Arm-2 (p = 0.562). There was a greater proportion of fungal infections in Arm-1 (19.2 vs 0 %, p = 0.032). CONCLUSIONS: ATG during the IPI was associated with lower frequency of recurrence of HCV in patients undergoing LT. This, however, did not affect the 1- and 2-year survival and the frequency of ACR, infections, or neoplasms.
RCT Entities:
BACKGROUND: Induction immunosuppression with anti-thymocyte globulin (ATG) provides potential benefits after liver transplantation (LT). However, its use in patients with LT and hepatitis C (HCV) is controversial. AIM: To evaluate the 1- and 2-year patient survival and HCV recurrence rate in patients receiving ATG during the induction phase of immunosuppression (IPI) after LT. METHODS: A total of 49 patients undergoing their first LT for HCV were randomized to receive ATG during IPI. Patient survival and HCV recurrence were determined at 1 and 2 years. The frequency of acute cellular rejection (ACR), infections, and neoplasms was also evaluated. RESULTS: Twenty-six patients were randomized to receive ATG (Arm-1) and 23 to standard induction therapy (Arm-2). Those given ATG had lower HCV recurrence (26.9 vs 73.9 %, p = 0.001). The 1- and 2-year patient survival rates were similar for both arms (p = 0.33). Infections occurred in 46.1 % subjects in Arm-1 and 34.7 % in Arm-2 (p = 0.562). There was a greater proportion of fungal infections in Arm-1 (19.2 vs 0 %, p = 0.032). CONCLUSIONS: ATG during the IPI was associated with lower frequency of recurrence of HCV in patients undergoing LT. This, however, did not affect the 1- and 2-year survival and the frequency of ACR, infections, or neoplasms.
Authors: Norah A Terrault; Mitchell L Shiffman; Anna S F Lok; Sammy Saab; Lan Tong; Robert S Brown; Gregory T Everson; K Rajender Reddy; Jeffrey H Fair; Laura M Kulik; Timothy L Pruett; Leonard B Seeff Journal: Liver Transpl Date: 2007-01 Impact factor: 5.799
Authors: Timothy M Schmitt; Melissa Phillips; Robert G Sawyer; Patrick Northup; Klaus D Hagspiel; Timothy L Pruett; Hugo J R Bonatti Journal: Dig Dis Sci Date: 2010-03-18 Impact factor: 3.199
Authors: Gianni Biancofiore; Maria L Bindi; Rubia Baldassarri; Anna Maria Romanelli; Gabriele Catalano; Franco Filipponi; Antonio Vagelli; Franco Mosca Journal: Transpl Int Date: 2002-06-20 Impact factor: 3.782
Authors: A Joseph Tector; Jonathan A Fridell; Richard S Mangus; Ashesh Shah; Martin Milgrom; Paul Kwo; Naga Chalasani; Hwan Yoo; Dale Rouch; Suthat Liangpunsakul; Scott Herring; Lawrence Lumeng Journal: Liver Transpl Date: 2004-03 Impact factor: 5.799
Authors: Speranta Iacob; Vito R Cicinnati; Philip Hilgard; Razvan A Iacob; Liana S Gheorghe; Irinel Popescu; Andrea Frilling; Massimo Malago; Guido Gerken; Christoph E Broelsch; Susanne Beckebaum Journal: Transplantation Date: 2007-07-15 Impact factor: 4.939
Authors: Manuel Rodríguez-Perálvarez; Marta Guerrero-Misas; Douglas Thorburn; Brian R Davidson; Emmanuel Tsochatzis; Kurinchi Selvan Gurusamy Journal: Cochrane Database Syst Rev Date: 2017-03-31
Authors: Abdulkareem M Albekairy; Wesam S Abdel-Razaq; Abdulmalik M Alkatheri; Tariq M Al Debasi; Nouf E Al Otaibi; Amjad M Qandil Journal: Int J Health Sci (Qassim) Date: 2018 Jul-Aug
Authors: Lawrence Mj Best; Jeffrey Leung; Suzanne C Freeman; Alex J Sutton; Nicola J Cooper; Elisabeth Jane Milne; Maxine Cowlin; Anna Payne; Dana Walshaw; Douglas Thorburn; Chavdar S Pavlov; Brian R Davidson; Emmanuel Tsochatzis; Norman R Williams; Kurinchi Selvan Gurusamy Journal: Cochrane Database Syst Rev Date: 2020-01-16