Complications in immunosuppressive therapy of liver transplant recipients

Salvatore Gruttadauria, Fabrizio Di Francesco, Duilio Pagano, Giovanni Vizzini, Davide Cintorino, Marco Spada, Fabio Tuzzolino, Bruno Gridelli

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: In liver transplantation (LT), modern immunosuppressive protocol is focused on early corticosteroid (CS) weaning. The aim of the study was to investigate all early transplant-related complications using Clavien grading system, in order to identify a significant relation in two homogenous groups of consecutive liver transplanted patients, only different for steroid avoidance in immunosuppressive regimen. Materials and Methods: One group was treated with a tacrolimus-based CS-free immunosuppressive protocol, the other one underwent tacrolimus plus low dose CS therapy. The preoperative continuous variables analyzed were age, gender, model for end-stage liver disease (MELD) score, and the pre-allocation score for predicting survival following liver transplantation (P-SOFT). Results: There were 39 patients in Group A (CS free) (37.9%), and 64 patients in Group B (CS on board) (62.1%). No statistically significant differences between the two groups were detected regarding the incidence and Clavien grade of complications (P = 0.116). No significant relation was revealed between Clavien rate of complications and tacrolimus-based CS-free immunosuppressive protocol, comparing the two subgroup of patient with P-SOFT score <6 and ≥ 6 (P = 0.193). This association was noted comparing the two subgroups on tacrolimus plus low dose CS regimen (P = 0.013). Conclusion: In this series, the use of CS in sick patient is associated with higher morbidity identified by the Clavien classification.

Original languageEnglish
JournalJournal of Surgical Research
Volume168
Issue number1
DOIs
Publication statusPublished - Jun 1 2011

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Immunosuppressive Agents
Adrenal Cortex Hormones
Liver
Tacrolimus
Therapeutics
Liver Transplantation
End Stage Liver Disease
Transplant Recipients
Weaning
Steroids
Morbidity
Transplants
Survival
Incidence

Keywords

  • complication
  • immunosuppression
  • liver transplantation
  • rejection

ASJC Scopus subject areas

  • Surgery

Cite this

Complications in immunosuppressive therapy of liver transplant recipients. / Gruttadauria, Salvatore; Di Francesco, Fabrizio; Pagano, Duilio; Vizzini, Giovanni; Cintorino, Davide; Spada, Marco; Tuzzolino, Fabio; Gridelli, Bruno.

In: Journal of Surgical Research, Vol. 168, No. 1, 01.06.2011.

Research output: Contribution to journalArticle

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abstract = "Background: In liver transplantation (LT), modern immunosuppressive protocol is focused on early corticosteroid (CS) weaning. The aim of the study was to investigate all early transplant-related complications using Clavien grading system, in order to identify a significant relation in two homogenous groups of consecutive liver transplanted patients, only different for steroid avoidance in immunosuppressive regimen. Materials and Methods: One group was treated with a tacrolimus-based CS-free immunosuppressive protocol, the other one underwent tacrolimus plus low dose CS therapy. The preoperative continuous variables analyzed were age, gender, model for end-stage liver disease (MELD) score, and the pre-allocation score for predicting survival following liver transplantation (P-SOFT). Results: There were 39 patients in Group A (CS free) (37.9{\%}), and 64 patients in Group B (CS on board) (62.1{\%}). No statistically significant differences between the two groups were detected regarding the incidence and Clavien grade of complications (P = 0.116). No significant relation was revealed between Clavien rate of complications and tacrolimus-based CS-free immunosuppressive protocol, comparing the two subgroup of patient with P-SOFT score <6 and ≥ 6 (P = 0.193). This association was noted comparing the two subgroups on tacrolimus plus low dose CS regimen (P = 0.013). Conclusion: In this series, the use of CS in sick patient is associated with higher morbidity identified by the Clavien classification.",
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AU - Spada, Marco

AU - Tuzzolino, Fabio

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N2 - Background: In liver transplantation (LT), modern immunosuppressive protocol is focused on early corticosteroid (CS) weaning. The aim of the study was to investigate all early transplant-related complications using Clavien grading system, in order to identify a significant relation in two homogenous groups of consecutive liver transplanted patients, only different for steroid avoidance in immunosuppressive regimen. Materials and Methods: One group was treated with a tacrolimus-based CS-free immunosuppressive protocol, the other one underwent tacrolimus plus low dose CS therapy. The preoperative continuous variables analyzed were age, gender, model for end-stage liver disease (MELD) score, and the pre-allocation score for predicting survival following liver transplantation (P-SOFT). Results: There were 39 patients in Group A (CS free) (37.9%), and 64 patients in Group B (CS on board) (62.1%). No statistically significant differences between the two groups were detected regarding the incidence and Clavien grade of complications (P = 0.116). No significant relation was revealed between Clavien rate of complications and tacrolimus-based CS-free immunosuppressive protocol, comparing the two subgroup of patient with P-SOFT score <6 and ≥ 6 (P = 0.193). This association was noted comparing the two subgroups on tacrolimus plus low dose CS regimen (P = 0.013). Conclusion: In this series, the use of CS in sick patient is associated with higher morbidity identified by the Clavien classification.

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