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AST/ASTS: Steroid-Free Liver Transplantation Decreases Incidence of Rejection, Diabetes NEW ORLEANS, LA -- MAY 11, 2001 -- A steroid-free treatment of rabbit anti-thymocyte globulin (rabbit ATG, Thymoglobulin) may decrease the incidence of organ rejection, diabetes and hepatitis C in liver transplant recipients, according to a study conducted by James D. Eason, M.D. of the Ochsner Multi-Organ Transplant Center. It is the largest study ever to evaluate completely steroid-free liver transplant treatment. Results of the study will be presented in Chicago, Illinois by Dr. Eason at Transplant 2001, the annual meeting of the American Society of Transplantation and American Society of Transplant Surgeons. Rabbit ATG is currently used in conjunction with steroids in the United States in the treatment of acute organ rejection episodes in transplant recipients. However, steroids have been associated with increased infections, post-transplant diabetes and recurrent hepatitis following liver transplantation. "This study shows that a steroid-free regimen using low-dose Thymoglobulin induction may decrease the risk for diabetes, infection and hepatitis C among patients who have undergone liver transplants, in addition to decreasing the incidence of rejection," said Dr. Eason. After a liver transplant, patients begin drug regimen to prevent their bodies from rejecting their new organ. Historically, steroids have been considered a key component of liver transplant treatment, even though they are associated with adverse side effects. In the study of 71 adult patients who had undergone a liver transplant, half received rabbit ATG, while the other half received steroid therapy. All participants also received a combination maintenance regimen of tacrolimus and mycophenolate mofetil (MMF). Patients treated without steroids had a lower incidence of post-transplant diabetes and recurrent hepatitis C. Four percent of steroid-free patients developed post-transplant diabetes, and only 50 percent developed recurrent hepatitis C. In comparison, 14 percent of steroid-treated patients developed post-transplant diabetes and 70 percent developed recurrent hepatitis C. Additionally, patients treated with rabbit ATG alone experienced a lower incidence and severity of rejection. Only 20 percent of those patients experienced acute rejection, compared to 30 percent who received the steroid protocol. Rejection was reversed in all patients who received rabbit ATG by increasing tacrolimus alone, while 60 percent of the patients in the steroid group required additional steroids for reversal of rejection. Patient survival was 91 percent in each group, with 87 percent graft survival. SOURCE: Ochsner Clinic & Hospital E-mail this page to a friend or colleague! To print, use this version