Application of immunosuppressive agents in children with pediatric living-donor liver transplantation
10.3760/cma.j.issn.0254-1785.2012.05.007
- VernacularTitle:小儿活体肝移植后免疫抑制剂的应用体会
- Author:
Xiaoyin TANG
;
Qiang XIA
;
Jianjun ZHANG
;
Longzhi HAN
;
Qigen LI
;
Ning XU
;
Xiaosong CHEN
;
Xin WANG
;
Yi LUO
;
Tianyu XING
;
Conghuan SHEN
;
Zhifeng XI
- Publication Type:Journal Article
- Keywords:
Liver transplantation;
Child,preschool;
Living donors;
Tacrolimus;
Cyclosporine
- From:
Chinese Journal of Organ Transplantation
2012;33(5):283-286
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo surnmarize the experience of tacrolimus or cyclosporine A-based immunosuppression after pediatric living-donor liver transplamation.Methods The clinical data of 30 children undergoing living-donor liver trarsplantation from October 2006 to January 2010 were analyzed retrospectively.In 30 patients,7 were given Tac-based immunosuppression (group A),10 given CsA-based immunosuppression (group B),and 13 switched from CsA to Tac for complications or adverse effects of drugs.Dosages and blood concentrations of immunosuppressants were recorded.Changes of liver and kidney functions were monitored.Incidence of rejection,infection and adverse effects of drugs were observed.ResultsIn the premise of the stable concentration and liver and kidney functions,the weight of children was increased by about 50％ and the per- kilogram dosage of CNIs was decreased significantly 1year postoperatively.There was no case of rejection in group A and 4 cases of rejection in group B(40％,4/10),and the original symptoms were gradually alleviated after the increased dosage in immunosuppressants.During the first 3 months,there was 1case of abdominal infection in group A (1/7) and 3 cases of lung infection in group B (3/10),and the original symptoms were gradually alleviated after anti-infective therapy.There was 1CMV lgM-positive case in group A (1/7) and 2 CMV IgM-positive cases in group B (2/10),and the original symptoms were gradually alleviated after using ganciclovir.The original symptoms of the 13 children switched from CsA to Tac were gradually alleviated.ConclusionThe two CNIs can be safely used in children undergoing pediatric livlng-donor liver transplantation.Both of them show the same effect in promoting the restoration of liver and kidney functions,but tacrolimus has more satisfactory effect in inhibiting the rejection and it has leas adverse effects.
