Tacrolimus and Sirolimus Once Daily Monotherapy Regimen as a Safe and Effective Long-Term Maintenance Immunosuppressive Therapy in Pediatric Liver Transplantation

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Article Type:
Research/Original Article (دارای رتبه معتبر)
Abstract:
Background

Long-term efficiency of attenuated immunosuppressive therapies is not well characterized in pediatric liver transplantation (LT).

Objective

To assess the efficiency of tacrolimus once daily (TAC-OD) and sirolimus once daily (SLR-OD) immunosuppression in pediatric LT.

Methods

We retrospectively evaluated 59 children who underwent LT in our center during 2002 to 2016. Those including children who underwent planned decrease in immunosuppressant dose (stable clinical conditions after 2 years of LT), and those who underwent unplanned decrease in immunosuppressant dose (because of complications such as post-transplant lymphoproliferative disorder [PTLD] and renal failure).

Results

25 of 59 children underwent planned decrease in immunosuppressant dosage (mean±SD duration of 4.5±1.8, range: 3–11 years); 34 had unplanned decrease (mean±SD of 1.3±0.6, range: 0.5–2.6 years). 19 of 25 children with planned conversion received TAC-OD; 6 received SLR-OD (22 with 1 mg/ day dose, and 3 with 1 mg every two days). Of 34 children with unplanned conversion, 27 received TACOD, 7 SLR-OD (25 children with 1 mg/day, 7 with 1 mg every two days, 1 with 0.5 mg/day TAC, and 1 with 0.5 mg TAC every two days). We found no adverse events including acute or chronic graft rejection, renal insufficiency, infections, PTLDs, or cardiovascular thrombotic events after initiation of the modified immunosuppression in none of the groups.

Conclusion

TAC-OD or SLR-OD monotherapies are safe and effective for long-term management of LT children with either stable clinical conditions or those with LT complications.

Language:
English
Published:
International Journal of Organ Transplantation Medicine, Volume:11 Issue: 4, Autumn 2020
Pages:
177 to 184
https://magiran.com/p2202965  
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