The optimal immunosuppressive protocol for the portal vein infusion of PGE1 and methylprednisolone in pediatric liver transplantation for fulminant hepatic failure of unknown etiology

Yohei Yamada, Ken Hoshino, Rie Irie, Hirofumi Tomita, Mototoshi Kato, Naoki Shimojima, Akihiro Fujino, Taizo Hibi, Masahiro Shinoda, Hideaki Obara, Osamu Itano, Shigeyuki Kawachi, Minoru Tanabe, Michiie Sakamoto, Yuukou Kitagawa, Tatsuo Kuroda

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

The outcome of LTx in pediatric patients with FHF of unknown etiology remains inferior to that of LTx in pediatric patients with cholestatic diseases. A higher incidence of steroid-resistant severe rejection has been increasingly recognized among the responsible factors. We assessed the efficacy of the administration of steroids and PGE1 via PVI in the management of LTx for FHF in pediatric patients. In our early cohort (1995–2007), seven patients who underwent LTx for FHF of unknown etiology were treated with conventional immunosuppressive therapy (calcineurin inhibitor and a steroid). Seven of eight grafts (one patient underwent re-LTx) sustained CV and/or CPV associated with ACR, and four patients died of a graft failure or infectious complications that were associated with the treatment for rejection. Of note, the pathological incidence of CV/CPV was significantly higher in recipients with FHF of unknown etiology than in recipients with biliary cholestatic disease during the same study period (87.5% vs. 13.7%, p 

Original languageEnglish
Pages (from-to)640-646
Number of pages7
JournalPediatric Transplantation
Volume20
Issue number5
DOIs
Publication statusPublished - 2016 Aug 1

Fingerprint

Acute Liver Failure
Alprostadil
Methylprednisolone
Immunosuppressive Agents
Portal Vein
Liver Transplantation
Pediatrics
Steroids
Transplants
Incidence
Therapeutics

Keywords

  • central perivenulitis
  • central venulitis
  • fulminant hepatic failure
  • pediatric liver transplantation
  • portal vein infusion

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Cite this

The optimal immunosuppressive protocol for the portal vein infusion of PGE1 and methylprednisolone in pediatric liver transplantation for fulminant hepatic failure of unknown etiology. / Yamada, Yohei; Hoshino, Ken; Irie, Rie; Tomita, Hirofumi; Kato, Mototoshi; Shimojima, Naoki; Fujino, Akihiro; Hibi, Taizo; Shinoda, Masahiro; Obara, Hideaki; Itano, Osamu; Kawachi, Shigeyuki; Tanabe, Minoru; Sakamoto, Michiie; Kitagawa, Yuukou; Kuroda, Tatsuo.

In: Pediatric Transplantation, Vol. 20, No. 5, 01.08.2016, p. 640-646.

Research output: Contribution to journalArticle

@article{87888b87636b4a428390eb2300bfd382,
title = "The optimal immunosuppressive protocol for the portal vein infusion of PGE1 and methylprednisolone in pediatric liver transplantation for fulminant hepatic failure of unknown etiology",
abstract = "The outcome of LTx in pediatric patients with FHF of unknown etiology remains inferior to that of LTx in pediatric patients with cholestatic diseases. A higher incidence of steroid-resistant severe rejection has been increasingly recognized among the responsible factors. We assessed the efficacy of the administration of steroids and PGE1 via PVI in the management of LTx for FHF in pediatric patients. In our early cohort (1995–2007), seven patients who underwent LTx for FHF of unknown etiology were treated with conventional immunosuppressive therapy (calcineurin inhibitor and a steroid). Seven of eight grafts (one patient underwent re-LTx) sustained CV and/or CPV associated with ACR, and four patients died of a graft failure or infectious complications that were associated with the treatment for rejection. Of note, the pathological incidence of CV/CPV was significantly higher in recipients with FHF of unknown etiology than in recipients with biliary cholestatic disease during the same study period (87.5{\%} vs. 13.7{\%}, p ",
keywords = "central perivenulitis, central venulitis, fulminant hepatic failure, pediatric liver transplantation, portal vein infusion",
author = "Yohei Yamada and Ken Hoshino and Rie Irie and Hirofumi Tomita and Mototoshi Kato and Naoki Shimojima and Akihiro Fujino and Taizo Hibi and Masahiro Shinoda and Hideaki Obara and Osamu Itano and Shigeyuki Kawachi and Minoru Tanabe and Michiie Sakamoto and Yuukou Kitagawa and Tatsuo Kuroda",
year = "2016",
month = "8",
day = "1",
doi = "10.1111/petr.12711",
language = "English",
volume = "20",
pages = "640--646",
journal = "Pediatric Transplantation",
issn = "1397-3142",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - The optimal immunosuppressive protocol for the portal vein infusion of PGE1 and methylprednisolone in pediatric liver transplantation for fulminant hepatic failure of unknown etiology

AU - Yamada, Yohei

AU - Hoshino, Ken

AU - Irie, Rie

AU - Tomita, Hirofumi

AU - Kato, Mototoshi

AU - Shimojima, Naoki

AU - Fujino, Akihiro

AU - Hibi, Taizo

AU - Shinoda, Masahiro

AU - Obara, Hideaki

AU - Itano, Osamu

AU - Kawachi, Shigeyuki

AU - Tanabe, Minoru

AU - Sakamoto, Michiie

AU - Kitagawa, Yuukou

AU - Kuroda, Tatsuo

PY - 2016/8/1

Y1 - 2016/8/1

N2 - The outcome of LTx in pediatric patients with FHF of unknown etiology remains inferior to that of LTx in pediatric patients with cholestatic diseases. A higher incidence of steroid-resistant severe rejection has been increasingly recognized among the responsible factors. We assessed the efficacy of the administration of steroids and PGE1 via PVI in the management of LTx for FHF in pediatric patients. In our early cohort (1995–2007), seven patients who underwent LTx for FHF of unknown etiology were treated with conventional immunosuppressive therapy (calcineurin inhibitor and a steroid). Seven of eight grafts (one patient underwent re-LTx) sustained CV and/or CPV associated with ACR, and four patients died of a graft failure or infectious complications that were associated with the treatment for rejection. Of note, the pathological incidence of CV/CPV was significantly higher in recipients with FHF of unknown etiology than in recipients with biliary cholestatic disease during the same study period (87.5% vs. 13.7%, p 

AB - The outcome of LTx in pediatric patients with FHF of unknown etiology remains inferior to that of LTx in pediatric patients with cholestatic diseases. A higher incidence of steroid-resistant severe rejection has been increasingly recognized among the responsible factors. We assessed the efficacy of the administration of steroids and PGE1 via PVI in the management of LTx for FHF in pediatric patients. In our early cohort (1995–2007), seven patients who underwent LTx for FHF of unknown etiology were treated with conventional immunosuppressive therapy (calcineurin inhibitor and a steroid). Seven of eight grafts (one patient underwent re-LTx) sustained CV and/or CPV associated with ACR, and four patients died of a graft failure or infectious complications that were associated with the treatment for rejection. Of note, the pathological incidence of CV/CPV was significantly higher in recipients with FHF of unknown etiology than in recipients with biliary cholestatic disease during the same study period (87.5% vs. 13.7%, p 

KW - central perivenulitis

KW - central venulitis

KW - fulminant hepatic failure

KW - pediatric liver transplantation

KW - portal vein infusion

UR - http://www.scopus.com/inward/record.url?scp=84978764833&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84978764833&partnerID=8YFLogxK

U2 - 10.1111/petr.12711

DO - 10.1111/petr.12711

M3 - Article

C2 - 27090203

AN - SCOPUS:84978764833

VL - 20

SP - 640

EP - 646

JO - Pediatric Transplantation

JF - Pediatric Transplantation

SN - 1397-3142

IS - 5

ER -