Low rejection rates with tacrolimus-based dual and triple regimens following liver transplantation

被引:13
作者
Boillot, O [1 ]
Baulieux, J [1 ]
Wolf, P [1 ]
Messner, M [1 ]
Cherqui, D [1 ]
Gugenheim, J [1 ]
Pageaux, G [1 ]
Belghiti, J [1 ]
Calmus, Y [1 ]
Le Treut, Y [1 ]
Neau-Cransac, M [1 ]
Samuel, D [1 ]
机构
[1] Hop Edouard Herriot, Serv Transplantat Hepat, F-69003 Lyon, France
关键词
clinical trial; dual versus triple drug regimen; liver transplantation; tacrolimus;
D O I
10.1034/j.1399-0012.2001.150303.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
We studied the outcome of 345 liver transplant patients who received tacrolimus-based immunosuppressive therapy either as a dual regimen (with corticosteroids, n = 172) or as a triple regimen (with corticosteroids and azathioprine, n = 173) for 3 months after transplantation (3-month cohort). A further analysis was conducted for the first 195 patients randomised (dual n = 100, triple n = 95) who were followed up for 12 months after transplantation (12-month cohort). For the 3-month cohort, patient survival was 90.7% (dual) and 91.9% (triple), graft survival after 3 months was 88.4% (dual therapy) and 89.6% (triple therapy). Acute rejections were experienced by 67/172, 39.0% of patients on dual therapy and by 60/173, 34.7% of patients on triple therapy; corticosteroid-resistant rejections were reported in 9 patients (5.2%) in either treatment group. The overall safety profile was similar for the two treatment groups. Significant differences, however, were found for thrombocytopenia (dual 13/172, 7.6%, triple 37/173, 21.4%, p < 0.001) and leukopenia (dual 4/172, 2.3%, triple 24/173, 13.9%, p < 0.001). For the 12-month cohort, patient survival was 85.6% (dual) and 88.4% (triple) after 1 year. Graft survival was 81.7% (dual) and 85.2% (triple) 12 months after transplantation. Acute rejections were reported for 38/100, 38.0% of patients on dual therapy and 36/95, 37.9% of patients on triple therapy, corticosteroid-resistant rejections were 7/100, 7.0% (dual) and 7/95, 7.4% (triple) of patients. In the 12-month cohort, no significant differences in the safety profiles of the treatment groups were found. We conclude that both tacrolimus-based dual and triple drug regimens provide effective and safe immunosuppression following orthotopic liver transplantation.
引用
收藏
页码:159 / 166
页数:8
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