Randomized trial of basiliximab induction versus steroid therapy in pediatric liver allograft recipients under tacrolimus immunosuppression

M. Spada, W. Petz, A. Bertani, S. Riva, A. Sonzogni, M. Giovannelli, E. Torri, G. Torre, M. Colledan, B. Gridelli

Research output: Contribution to journalArticlepeer-review

Abstract

Avoidance of corticosteroids could be beneficial after pediatric liver transplantation (LTx). To test this hypothesis, we performed a randomized prospective study to compare immunosuppression with tacrolimus (TAC) and steroids versus TAC and basiliximab (BAS) after pediatric LTx. Seventy-two patients were recruited, 36 receiving TAC and steroids and 36 TAC and BAS. The primary endpoint was the occurrence of the first rejection episode. Secondary endpoints were the cumulative incidence and severity of rejection, patient and graft survival, and incidence of adverse events. Overall 1-year patient and graft survival rates were 91.4% and 85.5% in the steroid group, and 88.6% and 80% in the BAS group (p = NS). Patients free from rejection were 87.7% in the BAS group and 67.7% in the steroid group (p = 0.036). The use of BAS was associated with a 63.6% reduction in incidence of acute rejection episodes. Overall incidence of infection was 72.3% in the steroid group and 50% in the BAS group (p = 0.035). We conclude that the combination of TAC with BAS is an alternative to TAC and steroid immunosuppression in pediatric LTx, which allows for a significant reduction in the incidence of acute rejection and infectious complications.

Original languageEnglish
Pages (from-to)1913-1921
Number of pages9
JournalAmerican Journal of Transplantation
Volume6
Issue number8
DOIs
Publication statusPublished - Aug 2006

Keywords

  • Glucocorticoids
  • Liver transplantation
  • Pediatric
  • Rejection
  • Simulect
  • Tacrolimus

ASJC Scopus subject areas

  • Immunology

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