Early post-operative intravenous tacrolimus in pediatric liver transplant recipients is not superior to oral tacrolimus
Tarek Abdelazeem Sabra
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Department of General Surgery, Pediatric Surgery Unit, Graduate School of Medicine, Assiut University, Assiut, Egypt
Al-Rajhi Liver Institute, Assiut University Hospitals, Assiut, Egypt
Search for more papers by this authorCorresponding Author
Hideaki Okajima
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Correspondence
Hideaki Okajima, Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University, Kyoto, Japan.
Email: [email protected]
Search for more papers by this authorAtsushi Yoshizawa
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Search for more papers by this authorEri Ogawa
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Search for more papers by this authorShinya Okamoto
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Search for more papers by this authorMohamed Abdelkader Osman
Department of General Surgery, Pediatric Surgery Unit, Graduate School of Medicine, Assiut University, Assiut, Egypt
Search for more papers by this authorYasser Saad-Eldin
Department of Pediatric Surgery, Graduate School of Medicine, Alexandria University, Alexandria, Egypt
Search for more papers by this authorShinji Uemoto
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Search for more papers by this authorTarek Abdelazeem Sabra
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Department of General Surgery, Pediatric Surgery Unit, Graduate School of Medicine, Assiut University, Assiut, Egypt
Al-Rajhi Liver Institute, Assiut University Hospitals, Assiut, Egypt
Search for more papers by this authorCorresponding Author
Hideaki Okajima
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Correspondence
Hideaki Okajima, Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kyoto University, Kyoto, Japan.
Email: [email protected]
Search for more papers by this authorAtsushi Yoshizawa
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Search for more papers by this authorEri Ogawa
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Search for more papers by this authorShinya Okamoto
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Search for more papers by this authorMohamed Abdelkader Osman
Department of General Surgery, Pediatric Surgery Unit, Graduate School of Medicine, Assiut University, Assiut, Egypt
Search for more papers by this authorYasser Saad-Eldin
Department of Pediatric Surgery, Graduate School of Medicine, Alexandria University, Alexandria, Egypt
Search for more papers by this authorShinji Uemoto
Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Search for more papers by this authorAbstract
We aimed to compare the early results of i.v. with p.o. TAC as a primary immunosuppressant in pediatric patients undergoing LT. This retrospective study enrolled 75 children who underwent LT and received TAC-steroid regimens as a primary immunosuppressant between September 2011 and October 2015 at our institution. Thirty-five recipients received TAC i.v. and 40 received TAC p.o. Early results were evaluated and compared, including ACR, EBV, or CMV infection; renal adverse effects; and hospital stay. Comparisons of 90-day post-transplant results showed that the rates of overall viral (74% vs 40% P < 0.002), EBV (46% vs 17.5% P < 0.008), and CMV (51% vs 30% P = 0.05) infections were significantly higher in the i.v. than in the p.o. group. Neither regimen has any adverse effects on renal function. There were no between-group differences in ACR incidence and severity, serum creatinine concentration, and hospital stay. Patient and graft survival rates at 3 months and 1 year did not differ significantly between the two groups. Compared with p.o. treatment, i.v. administration of high TAC concentration did not have beneficial post-transplant effects on ACR incidence and severity, while increasing the incidence of viral infections in pediatric LT.
CONFLICT OF INTEREST
The authors of this manuscript declare no conflicts of interest.
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