Improved survival and less rejection possible with drug regimen

A new drug combination can be effective for reducing incidences of rejection in liver transplant patients than present day treatment options, according to Transplant surgeons at Thomas Jefferson University Hospital in Philadelphia.

Basiliximab, a monoclonal antibody, as part of a group of drugs that included a standard anti-rejection agent (tacrolimus), and low doses of steroids was used by a team of surgeons, led by Ignazio Marino, M.D., director of the Division of Liver Transplantation and Hepato-biliary Surgery at Thomas Jefferson University Hospital.

From Sciencedaily.com:

Tacrolimus is a drug that suppresses the immune system by inhibiting an enzyme (calcineurin) crucial for T-cell proliferation, which is important in the immune process. The Jefferson surgeons' trial marks the first time anyone had evaluated the effectiveness and safety of basiliximab and tacrolimus to suppress the immune system to prevent the body's rejection of a liver.

"We think we have much less toxicity in the short term because we use less tacrolimus," he says. They also expect less toxicity in the long term as well because they used fewer steroids. As a result, he says, they expect fewer complications associated with long-term steroid use, which includes hypertension, osteoporosis and diabetes.

Dr. Marino has also discovered that basiliximab may affect hepatitis C virus (HCV) recurrence. "We also suspect that the recurrence of HCV is lower, though we don't have enough data to confirm this," he says. Typically, immunosuppressed liver transplant patients experience high rates of HCV recurrences, Dr. Marino notes, because the virus has fewer restrictions on its growth. Perhaps, he says, the anti-IL2 monoclonal has some mechanism affecting the replication of the HCV.

Dr. Marino, who is also professor of surgery at Jefferson Medical College of Thomas Jefferson University and the interim director of the Division of Transplantation at Thomas Jefferson University Hospital, remarked that adding basiliximab results in significant reduction of rejection rate to 12 percent.