tacrolimus and Jaundice

Topics: Antibodies, Monoclonal; Antigens, CD20; ATP Binding Cassette Transporter, Subfamily B, Member 11; ATP-Binding Cassette Transporters; Bile Acids and Salts; Cholestasis; Female; Humans; Immunosuppressive Agents; Infant; Jaundice; Liver; Liver Transplantation; Male; Tacrolimus

Topics: Antiviral Agents; Fatal Outcome; Hepatitis C; Humans; Immunosuppressive Agents; Interferon alpha-2; Interferon-alpha; Jaundice; Liver Cirrhosis; Liver Transplantation; Male; Middle Aged; Polyethylene Glycols; Postoperative Complications; Recombinant Proteins; Ribavirin; Tacrolimus

Topics: Child; Drug Therapy, Combination; Female; Graft Rejection; Humans; Immunosuppressive Agents; Jaundice; Liver Function Tests; Liver Transplantation; Mycophenolic Acid; Sirolimus; Tacrolimus; Treatment Outcome

The effects of low dose FK506 therapy (0.1 mg/ kg/day x 1 day) on graft survivals were analyzed, and the feasibility of splenectomy was assessed. ACI strain liver grafts were orthotopically implanted into LEW male rat recipients. In the control group, the survival period was 10.4 +/- 1.4 days. In the group treated with splenectomy, the survival period was 13.4 +/- 2.0 days. In the groups with low dose FK506 therapy, the survival periods were 22.7 +/- 6.7 and 39.7 +/- 6.3 days with or without splenectomy, respectively. Rats in the group with average dose FK506 (1.0 mg/kg/day x 7 days) survived more than 100 days. In summary, the effect of low dose FK506 therapy was relatively limited. Splenectomy by itself was marginally effective; however, this effect was enhanced when combined with low dose FK506 therapy.

Topics: Animals; Body Weight; Dose-Response Relationship, Drug; Graft Rejection; Graft Survival; Immunosuppressive Agents; Jaundice; Liver Transplantation; Male; Postoperative Complications; Rats; Splenectomy; Tacrolimus

Two infants with biliary atresia who exhibited three-fold increased trough levels of tacrolimus and required reduced doses during episodes of acute infantile diarrhea within 5 months of liver transplantation are described. The cause of the increase was not explained simply by hemoconcentration as a result of significant loss of extracellular fluid during these episodes. It does highlight an important issue: that of the continuing need to carefully monitor the trough levels of tacrolimus in such infants.

Topics: Acute Disease; Biliary Atresia; Diarrhea, Infantile; Female; Humans; Immunosuppressive Agents; Infant; Jaundice; Liver Transplantation; Portoenterostomy, Hepatic; Tacrolimus

An account is given of the 6- to 12-month survival, and causes of failure in 110 consecutive patients who underwent primary liver transplantation under treatment from the outset with FK 506 and steroids. The patient survival is 92.7%, and the first graft survival is 87.3%. At a very high frequency, the patients achieved good graft function, and they had a relatively low morbidity that was partially ascribable to minimal use and early discontinuance (in 60% of cases) of steroids. Renal dysfunction and other adverse findings were largely confined to patients with poor initial graft function and consequent apparent alteration of the kinetics of FK 506 elimination, causing functional overdosage. Results compare very favorably with our past record using conventional immunosuppression, and support the belief that FK 506 is a superior immunosuppressive agent which is suitable for chronic administration.

Topics: Adult; Alanine Transaminase; Anti-Bacterial Agents; Aspartate Aminotransferases; Bilirubin; Blood Urea Nitrogen; Cause of Death; Cholesterol; Creatine; Cyclosporins; gamma-Glutamyltransferase; Graft Survival; Humans; Hypertension; Immunosuppression Therapy; Immunosuppressive Agents; Jaundice; Kidney; Liver Transplantation; Prednisone; Survival Analysis; Tacrolimus; Uric Acid