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Pediatric liver transplantation with daclizumab induction therapy
Transplantation
  • Thomas Heffron
  • Todd Pillen
  • Gregory Smallwood, Philadelphia College of Osteopathic Medicine
  • David Welch
  • Brad Oakley
  • Rene Romero
Document Type
Article
Publication Date
1-1-2003
Abstract
Background. A new class of monoclonal antibodies (non-T-cell depleting) has gained favor for induction therapy after transplantation. This study evaluated the non-T-cell depleting antibody to the CD25 cell, daclizumab, as a single-dose induction agent immediately after pediatric liver transplantation to spare the use of the calcineurin inhibitor, tacrolimus, for 7 days in respect to both efficacy and renal function. Methods. From January 1998 to November 2001, 81 pediatric orthotopic liver transplant recipients receiving 89 liver grafts were evaluated. The treatment arm (n=61) received daclizumab 1 mg/kg immediately after liver transplantation along with mycophenolate, steroids, and, on postoperative day 7, tacrolimus. The control group did not receive induction therapy, whereas tacrolimus, mycophenolate, and steroids were started immediately after surgery. Results. The induction group had fewer patients with rejection within the first 30 days after liver transplantation (9 [14.8%] vs. 10 [50%]; P=0.003). The mean time to first rejection was similar between groups (12.1 [±7.8] days vs. 18.5 [±8.1] days; P=not significant). There was a 3.39 increase in relative risk to develop rejection within the first 30 days after orthotopic liver transplantation if the patient did not receive induction therapy (relative risk=3.39; 95% confidence interval [1.61, 7.14]). Two-year actuarial survival for the induction group was 93.2% compared with 85% in the control; graft survival was also similar between groups (87.8% vs. 72.7%) at 2 years. Conclusion. Daclizumab 1 mg/kg given immediately after pediatric liver transplantation and withholding tacrolimus, is safe, efficacious, and reduces rejections within the first 30 days after surgery.
Comments

This article was published in Transplantation, Volume 75, Issue 12, Pages 2040-2043.

The published version is available at http://journals.lww.com/transplantjournal/Abstract/2003/06270/.

Copyright © 2003 LWW.

Citation Information
Thomas Heffron, Todd Pillen, Gregory Smallwood, David Welch, et al.. "Pediatric liver transplantation with daclizumab induction therapy" Transplantation Vol. 75 Iss. 12 (2003) p. 2040 - 2043
Available at: http://works.bepress.com/gregory_smallwood/45/