Pitt study: Chronic rejection rare for pediatric liver transplant patients on tacrolimus

WASHINGTON, D.C., April 30 Pediatric liver transplant patients taking the immunosuppressant tacrolimus do not appear to be at risk for developing chronic rejection, according to a long-term follow-up study of 166 children transplanted at the University of Pittsburgh between 1989 and 1992. The results of the study were presented today at the American Transplant Congress being held at the Marriott Wardman Park Hotel in Washington, D.C.

Only four children of the 166 being treated with tacrolimus (Prograf ) developed chronic rejection, most likely because the drugs were either stopped or drastically reduced so that doctors could treat life-threatening infections or complications, reported Ashok Jain, M.D., assistant professor of surgery at the University of Pittsburghs Thomas E. Starzl Transplantation Institute.

One child, who developed hepatitis C and post-transplant lymphoproliferative disease, a complication involving tumor growth, was off immunosuppression for eight months and eventually lost his graft. Two children developed Epstein Barr virus, and one patient developed chicken pox. Although one of the patients had also been noncompliant with taking his medication, the chronic rejection was resolved in the three children once normal tacrolimus dosages were resumed.

Overall at a mean follow-up of nine years, 85 percent of the 166 children are still alive (25 children died), with graft survival at 80 percent (15 required retransplantation), reported Dr. Jain.

There was a total absence of chronic rejection in the pediatric population who were maintained on tacrolimus. Inability to maintain baseline immunosuppression for life-threatening infection and/or noncompliance of the patient to take medication was found to be the cause of chronic rejection, reported Dr. Jain.


Contact: Lisa Rossi
University of Pittsburgh Medical Center

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