Liver allograft radiotherapy to treat rejection in children: Efficacy in orthotopic liver transplantation and long-term safety

Xavier Stephenne, Mustapha Najimi, Magda Janssen, Raymond Reding, Jean de Ville de Goyet, Etienne M. Sokal

Research output: Contribution to journalArticle

Abstract

Background: We studied, retrospectively, the efficacy to control rejection and long-term safety of liver allograft radiotherapy (RT) performed in 14 children. Long-term safety data were collected with the prospect of possible use of RT in liver cell transplantation (LCT). Methods: Immune suppression included cyclosporine, azathioprine and prednisone. In case of intractable rejection, low-dose allograft RT was administered daily for 3 days, and short-term efficacy was evaluated by liver enzyme assays and histology. The long-term outcome was compared with that of 122 patients undergone transplantation and who had similar treatment, but no RT. Results: Survival at 15 years was 71.4% vs 69.7% in the comparison group. In the RT group, rejection control was complete in six of 14 children and partial in two, all being alive and well 14-18 years later. Ten of 14 children had follow-up biopsy. Six children had normal histology and four had mild unspecific fibrosis. The long-term follow-up biopsy in the comparison group showed fibrosis in 42 of 85 children. The incidence of complications was similar in both groups. Conclusions: This series shows that, such a RT regimen appeared to be efficient and safe as a rescue treatment for acute rejection. Provided that further investigations in animal models show a certain benefit of low-dose irradiation around LCT, such a regimen could be proposed in human liver cell transplant programmes.

Original languageEnglish
Pages (from-to)1108-1113
Number of pages6
JournalLiver International
Volume25
Issue number6
DOIs
Publication statusPublished - Dec 2005

Keywords

  • Liver
  • Liver cell transplantation
  • Radiotherapy
  • Rejection
  • Retrospective study

ASJC Scopus subject areas

  • Hepatology

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