Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 16 January 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Weaning of immunosuppression in living donor liver transplant recipients

A study in the latest issue of Transplantation finds that weaning of immunosuppression in living donor transplant patients may be successfully achieved.

News image

fiogf49gjkf04

It has been reported that withdrawal of immunosuppression in cadaveric liver transplantation may be a possibility. A new study has now examined whether this may be the case in living donor liver transplant recipients.

The research, conducted by a team from the universities of Kyoto and Nagasaki, Japan, investigated 63 patients whom, between June 1990 and October 1999, were considered to be weaned from immunosuppression.

These patients consisted of 26 electively weaned patients and 37 nonelectively weaned patients. In the latter case, removal of immunosuppression was initiated either forcibly or incidentally, mainly due to infection.

Elective weaning was carried out only in patients who survived more than 2 years after transplantation, maintained a good graft function and had no rejection episodes in the preceding 12 months.

Such patients received a gradual reduction in the frequency of tacrolimus administration from the conventional twice daily dose until the start of weaning to q.d., 4 times a week, 3 times a week, twice a week, once a week, once a fortnight, once a month and finally, until patients were completely weaned. Each weaning period lasted from 3 to 6 months.

In the case of nonelective weaning, the reduction method depended on the clinical course of each individual case.

38% of patients were completely weaned
Transplantation

Reintroduction of tacrolimus, or an additional steroid bolus, was administered if patients were clinically diagnosed as developing rejection during the course of weaning.

A complete withdrawal of tacrolimus was achieved in 24 patients (38%), with a median drug-free period of 23.5 months (range, 3-69 months).

In the case of 23 patients (36.5%), weaning at various stages is still ongoing, while 16 patients (25%) encountered rejection while weaning at a median period of 9.5 months (range, 1-63 months) from the start of weaning. Additional steroid bolus therapy or tacrolimus reintroduction was successfully used to treat all 16 of these patients.

Mitsuhisa Takatsuki, a co-author of the report, said the research team had been able to achieve a "complete withdrawal of immunosuppression in some selected patients."

He added that, "Although the mechanism of graft acceptance in these patients has yet to be elucidated, we believe that a majority of long-term patients undergoing living donor liver transplantation may be potential candidates to be successfully weaned from immunosuppression."

Transplantation 2001; 72 (3): 449-454
21 August 2001

Go to top of page Email this page Email this page to a colleague

 16 January 2018 
Bundle of care in GI cancer surgery
 16 January 2018 
Anxiety about colonoscopy
 16 January 2018 
Thiopurines and colorectal neoplasia in IBD
 15 January 2018 
Risks of death after liver transplants for liver cancer
 15 January 2018 
Recent advances in hepatocellular carcinoma
 15 January 2018 
Ileostomy output using telemedicine
 12 January 2018 
Surveillance protocols after colorectal cancer resection
 12 January 2018 
Biologic therapy by pregnant women with IBD and infant vaccines
 12 January 2018 
Biologic therapies for IBD in the USA
 11 January 2018 
Genetic risk factors in GERD
 11 January 2018 
Predictor of colorectal adenoma
 11 January 2018 
Ectopic pregnancy in IBD 
 10 January 2018 
Fecal immunochemical tests for colorectal cancer screening
 10 January 2018 
Risk factors for advanced NAFLD
 10 January 2018 
Dyspepsia prevalence with gastroesophageal reflux–type symptoms
 09 January 2018 
Screening intervals for people with family histories of colorectal cancer
 09 January 2018 
Financial impact of colorectal cancer
 09 January 2018 
Current practice and future research in autoimmune hepatitis
 08 January 2018 
Improving prognosis in patients with primary sclerosing cholangitis
 08 January 2018 
Reliability of the IBD index
 08 January 2018 
Aprepitant and nausea with gastroparesis
 05 January 2018 
Autoimmune pancreatitis and IBD
 05 January 2018 
Primary nonresponse to infliximab therapy
 05 January 2018 
Anesthesia assistance in outpatient colonoscopy
 04 January 2018 
Dietary polyphenols in the etiology of IBD
 04 January 2018 
Yoga vs low-FODMAP in IBS
 04 January 2018 
Local esophageal food allergen injections in eosinophilic esophagitis
 03 January 2018 
Population health management for IBD
 03 January 2018 
GERD in asthma and COPD
 03 January 2018 
Critical research gaps in colorectal cancer
 22 December 2017 
Costs of extrahepatic manifestations of Hep C
 22 December 2017 
Cholera vaccine and risk of death in colorectal cancer
 22 December 2017 
Colonoscopy after colorectal cancer resection
 21 December 2017 
Human oral microbiome and pancreatic cancer risk
 21 December 2017 
Health management for IBD
 21 December 2017 
PPI and Alzheimer's disease
 20 December 2017 
Incidence of biopsy-verified celiac disease
 20 December 2017 
Osteoporotic fractures in Barrett's esophagus
 20 December 2017 
Management of abnormal liver blood tests
 19 December 2017 
Family burden of pediatric Crohn's in the USA
 19 December 2017 
Alcohol abstinence and alcoholic hepatitis
 19 December 2017 
Early readmission in IBD patients
 18 December 2017 
Colorectal cancer mortality with low-risk adenomas at colonoscopy
 18 December 2017 
Disease activity indices in celiac disease
 18 December 2017 
Smoking behaviour predicted the risk of surgery in Crohn's
 15 December 2017 
Molecular classification of Crohn's disease
 15 December 2017 
Medical cannabinoid legalization policy and vomiting
 15 December 2017 
Inflammatory diet pattern and colorectal cancer risk
 14 December 2017 
PPIs and gastric cancer after H.pylori eradication
 14 December 2017 
H. pylori eradication therapies in countries with clarithromycin resistance
 13 December 2017 
Disease severity in NAFLD
 13 December 2017 
Tryptophan metabolism and IBD activity
 12 December 2017 
Risk factors in undiagnosed cirrhosis
 12 December 2017 
Monitored anesthesia care for outpatient GI endoscopy
 12 December 2017 
High-risk colorectal cancer patients
 06 December 2017 
Reflux-induced chronic cough 
 06 December 2017 
Systemic inflammatory response syndrome in acute-on-chronic liver failure
 06 December 2017 
Preventing hepatic encephalopathy-related readmissions
 05 December 2017 
Thiopurines and colorectal cancer in IBD
 05 December 2017 
Childhood obesity into adulthood

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us