Validation of Steroid-Free Immunosuppression Regimen after Liver Transplantation

Ken Fukumitsu
2015 Journal of Clinical Gastroenterology and Treatment  
Various regimens are used for immunosuppression for liver transplantation (LT). Even though steroid is one of the key drugs, it has many adverse effects, especially infection. A steroidfree immunosuppression protocol has been recently adopted at our institute. In this report, we evaluate usability of such protocol. Methods: The study comprised 141 patients who underwent LT from January 2009 until November 2013 excluding the cases with ABO-incompatible transplantation or with steroid
more » ... steroid administration before LT. After February 2011, steroid has been replaced with mycophenolate mofetil in the immunosuppression protocol. We analyzed the rate of bacteremia, acute cellular rejection within 3 months after LT and patients' overall survival between the earlier steroid-containing protocol and latter steroid-free protocol. Result: The incidence of post-transplant bacteremia tended to decrease, but insignificantly (P = 0.086), while rejection tended to occur more frequently, but insignificantly (P = 0.367) after LT under the steroid-free protocol, however, most of rejection cases were controlled by steroid pulse treatment. There was no significant difference in overall survival between both protocols (P = 0.281). Conclusion: Steroid-free immunosuppression could be of value in LT in decreasing risk of bacteremia without the complication of rejection after LT.
doi:10.23937/2469-584x/1510008 fatcat:hxwbi3ze3va5rcvxiw53mkgscy