BACKGROUND： The benefits of the application of basiliximab induction therapy in liver transplantation are not clear. The present meta-analysis was to evaluate the pros and cons of basiliximab use in liver transplanta...BACKGROUND： The benefits of the application of basiliximab induction therapy in liver transplantation are not clear. The present meta-analysis was to evaluate the pros and cons of basiliximab use in liver transplantation. DATA SOURCES： We searched the associated publications in English from July 1998 to December 2015 in the following databases： MEDLINE, Pub Med, Ovid, EMBASE, Web of Science and Cochrane Library.RESULTS： Basiliximab significantly decreased the incidence of de novo diabetes mellitus after liver transplantation（RR=0.56; 95% CI： 0.34-0.91; P=0.02）. Subgroup analysis showed that basiliximab in combination with steroids-free immunosuppressant significantly decreased the incidence of biopsy-proven acute rejection（RR=0.62; 95% CI： 0.39-0.97; P=0.04） and new-onset hypertension（RR=0.62; 95% CI： 0.42-0.93; P=0.02）.CONCLUSIONS： Basiliximab may be effective in reducing de novo diabetes mellitus. What is more, basiliximab in combination with steroids-free immunosuppressant shows statistical benefit to reduce biopsy-proven acute rejection and de novo hypertension.展开更多
Objective To investigate the effectiveness and tolerability of immunosuppressive regimen with daclizumab induction therapy. Methods In study group,139 patients received immunosuppressive regimen with daclizumab induct...Objective To investigate the effectiveness and tolerability of immunosuppressive regimen with daclizumab induction therapy. Methods In study group,139 patients received immunosuppressive regimen with daclizumab induction therapy. In historical control group,展开更多
To the Editor:To reduce the risk of acute rejection(AR)after renal transplantation,immunosuppressive induction therapy has been commonly used in the perioperative period.At present,rabbit anti-thymocyte globulin(rATG)...To the Editor:To reduce the risk of acute rejection(AR)after renal transplantation,immunosuppressive induction therapy has been commonly used in the perioperative period.At present,rabbit anti-thymocyte globulin(rATG)and basiliximab are the two main induction agents used for kidney transplantation.In adult kidney transplantation,the incidence of AR with rATG induction is generally lower than that with basiliximab.[1]Children have different immune systems than adults do.In pediatric kidney transplantation,which induction therapy is more effective in preventing early AR is an important clinical question worth answering.Because there are few reports in this field and differences in the immune systems of children at different ages,we have now conducted a total and age-stratified analysis of Chinese multicenter cohort data to compare the AR rates and other outcomes between rATG and basiliximab induction therapy groups in pediatric deceased-donor kidney transplantation.展开更多
BACKGROUND Autoimmune hepatitis(AIH)is typically treated with immunomodulators and steroids.However,some patients are refractory to these treatments,necessitating alternative approaches.Biological therapies have recen...BACKGROUND Autoimmune hepatitis(AIH)is typically treated with immunomodulators and steroids.However,some patients are refractory to these treatments,necessitating alternative approaches.Biological therapies have recently been explored for these difficult cases.AIM To assess the efficacy and safety of biologics in AIH,focusing on patients unresponsive to standard treatments and evaluating outcomes such as serological markers and histological remission.METHODS A case-based systematic review was performed following the PRISMA protocol to evaluate the efficacy and safety of biological therapies in AIH.The primary focus was on serological improvement and histological remission.The secondary focus was on assessing therapy safety and additional outcomes.A standardized search command was applied to MEDLINE,EMBASE,and Cochrane Library databases to identify relevant studies.Inclusion criteria encompassed adult AIH patients treated with biologics.Data were analyzed based on demographics,prior treatments,and therapy-related outcomes.A narrative synthesis was employed to address biases and provide a comprehensive overview of the evidence.RESULTS A total of 352 studies were reviewed,with 30 selected for detailed analysis.Key findings revealed that Belimumab led to a favourable response in five out of eight AIH patients across two studies.Rituximab demonstrated high efficacy,with 41 out of 45 patients showing significant improvement across six studies.Basiliximab was assessed in a single study,where the sole patient treated experienced a beneficial outcome.Additionally,a notable number of AIH cases were induced by anti-tumor necrosis factor(TNF)medications,including 16 cases associated with infliximab and four cases with adalimumab.All these cases showed improvement upon withdrawal of the biologic agent.CONCLUSION Belimumab and Rituximab show promise as effective alternatives for managing refractory AIH,demonstrating significant improvements in clinical outcomes and liver function.However,the variability in patient responses to different therapies highlights the need for personalized treatment strategies.The risk of AIH induced by anti-TNF therapies underscores the need for vigilant monitoring and prompt symptom recognition.These findings support the incorporation of biologic agents into AIH treatment protocols,particularly for patients who do not respond to conventional therapies.展开更多
Background Induction therapy are utilized to achieve an adequate immunosuppression at the time of transplantation. The use of basiliximab or anti-thymocyte globulin （ATG） for induction therapy has significantly redu...Background Induction therapy are utilized to achieve an adequate immunosuppression at the time of transplantation. The use of basiliximab or anti-thymocyte globulin （ATG） for induction therapy has significantly reduced the incidence of acute rejection episodes post-transplantation. The purpose of this study was to compare the efficacy and safety of the basiliximab in patients with immuno-induction therapy after kidney transplantation with the ATG. Methods A retrospective analysis was carried out in kidney transplant recipients including 146 patients with the basiliximab and 116 cases with the ATG and the acute rejection, graft function, infective complications and 1-year and 5-year actuarial patient and graft survival after renal transplantation were compared between the two treatment groups. Results There were no statistically significant difference between groups regarding age, sex, cold ischemic time, warm ischemic time, human leukocyte antigen （HLA） matching type between the donor and recipient, lymphotoxin test and the use of immunosuppressive agents. There was no statistical significance regarding the incidence of the acute rejection （9.59% vs. 8.62%, P=0.481） and delayed graft function （10.27% vs. 9.48%, P=0.501） between groups. There were significantly lower lung infection incidence （5.48% vs. 12.93%, P=0.029） in the basiliximab-treated group in comparison with the ATG-treated group. One-year patient and graft survival rates were 98%, 97% for the basiliximab-treated group, and 95%, 73% for the ATG-treated group, respectively. Five-year patient and graft survival rates were 92%, 86% for the basiliximab-treated group and 93%, 72% for the ATG-treated group, respectively. Log rank test showed statistically significant difference with P=0.038 for patients and P=-0.033 for grafts, respectively. There were significantly lower the incidence of granulocytopenia （8.22% vs. 17.24%, P=0.022） and thrombocytopenia （4.11% vs. 19.83%, P=0.000） after transplantation in the basiliximab-treated group in comparison with the ATG-treated group. There was no statistical significance regarding the incidence of the heart dysfunction after transplantation between the two groups （6.16% vs. 6.90%, P=0.502）. Conclusion The immuno-induction therapy with the basiliximab in kidney transplant recipients is efficient and safe with less complication compared with the ATG.展开更多
目的:肝移植受者术后感染率高,识别出具有细菌与真菌感染高风险的患者将有利于预防疾病和改善肝移植受者的长期预后。本研究旨在了解肝移植术后早期(2个月内)细菌及真菌感染的病原菌组成、分布和预后,并分析其危险因素。方法:收集2020年...目的:肝移植受者术后感染率高,识别出具有细菌与真菌感染高风险的患者将有利于预防疾病和改善肝移植受者的长期预后。本研究旨在了解肝移植术后早期(2个月内)细菌及真菌感染的病原菌组成、分布和预后,并分析其危险因素。方法:收集2020年5月至2021年10月在中南大学湘雅三医院行肝移植手术的受者发生细菌与真菌感染的病原体组成、分布和预后的数据,并分析感染发生的危险因素。结果:105例肝移植受者中75例发生了106株细菌或真菌感染,肝移植术后早期感染发生率为71.4%(75/105)。病原菌构成中G-杆菌处于优势(49/106,46.2%),G+球菌次之(31/106,29.2%)。G-杆菌中最常见者为鲍曼不动杆菌(13/106,12.3%)。G+球菌中最常见者为屎肠球菌(20/106,18.9%)。最常见感染部位为肺部感染(38/105,36.2%)及多部位感染(30/105,28.6%)。术后死亡6例(6/105,5.7%),均为感染患者。单因素分析显示术前终末期肝病模型(model for end stage liver disease,MELD)评分、术前半个月内抗生素使用、术前2个月内感染、术中红细胞输注量≥8 U、术后导尿管留置≥4 d及使用巴利昔单抗≥40 mg与感染发生有关;多元logistic回归分析显示仅术前两个月内感染(OR=5.172,95%CI:1.905~14.039,P<0.01)是肝移植术后细菌与真菌感染发生的独立危险因素,使用巴利昔单抗≥40 mg(OR=0.197,95%CI:0.051~0.762,P<0.05)的肝移植受者术后细菌与真菌感染率降低。结论:肝移植术后早期细菌与真菌感染发生率高,感染后病死率明显高于非感染患者,最常见感染部位为肺部,最多见病原体为G-杆菌。术前2个月内感染的受者术后易发生细菌与真菌感染。规范使用巴利昔单抗有助于减少肝移植术后感染的发生。展开更多
基金supported by a grant from the Science and Technology project of Shenyang(F13-212-9-00)
文摘BACKGROUND： The benefits of the application of basiliximab induction therapy in liver transplantation are not clear. The present meta-analysis was to evaluate the pros and cons of basiliximab use in liver transplantation. DATA SOURCES： We searched the associated publications in English from July 1998 to December 2015 in the following databases： MEDLINE, Pub Med, Ovid, EMBASE, Web of Science and Cochrane Library.RESULTS： Basiliximab significantly decreased the incidence of de novo diabetes mellitus after liver transplantation（RR=0.56; 95% CI： 0.34-0.91; P=0.02）. Subgroup analysis showed that basiliximab in combination with steroids-free immunosuppressant significantly decreased the incidence of biopsy-proven acute rejection（RR=0.62; 95% CI： 0.39-0.97; P=0.04） and new-onset hypertension（RR=0.62; 95% CI： 0.42-0.93; P=0.02）.CONCLUSIONS： Basiliximab may be effective in reducing de novo diabetes mellitus. What is more, basiliximab in combination with steroids-free immunosuppressant shows statistical benefit to reduce biopsy-proven acute rejection and de novo hypertension.
文摘Objective To investigate the effectiveness and tolerability of immunosuppressive regimen with daclizumab induction therapy. Methods In study group,139 patients received immunosuppressive regimen with daclizumab induction therapy. In historical control group,
基金supported by the Clinical Research Flagship Project of Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology(No.2019CR108).
文摘To the Editor:To reduce the risk of acute rejection(AR)after renal transplantation,immunosuppressive induction therapy has been commonly used in the perioperative period.At present,rabbit anti-thymocyte globulin(rATG)and basiliximab are the two main induction agents used for kidney transplantation.In adult kidney transplantation,the incidence of AR with rATG induction is generally lower than that with basiliximab.[1]Children have different immune systems than adults do.In pediatric kidney transplantation,which induction therapy is more effective in preventing early AR is an important clinical question worth answering.Because there are few reports in this field and differences in the immune systems of children at different ages,we have now conducted a total and age-stratified analysis of Chinese multicenter cohort data to compare the AR rates and other outcomes between rATG and basiliximab induction therapy groups in pediatric deceased-donor kidney transplantation.
文摘BACKGROUND Autoimmune hepatitis(AIH)is typically treated with immunomodulators and steroids.However,some patients are refractory to these treatments,necessitating alternative approaches.Biological therapies have recently been explored for these difficult cases.AIM To assess the efficacy and safety of biologics in AIH,focusing on patients unresponsive to standard treatments and evaluating outcomes such as serological markers and histological remission.METHODS A case-based systematic review was performed following the PRISMA protocol to evaluate the efficacy and safety of biological therapies in AIH.The primary focus was on serological improvement and histological remission.The secondary focus was on assessing therapy safety and additional outcomes.A standardized search command was applied to MEDLINE,EMBASE,and Cochrane Library databases to identify relevant studies.Inclusion criteria encompassed adult AIH patients treated with biologics.Data were analyzed based on demographics,prior treatments,and therapy-related outcomes.A narrative synthesis was employed to address biases and provide a comprehensive overview of the evidence.RESULTS A total of 352 studies were reviewed,with 30 selected for detailed analysis.Key findings revealed that Belimumab led to a favourable response in five out of eight AIH patients across two studies.Rituximab demonstrated high efficacy,with 41 out of 45 patients showing significant improvement across six studies.Basiliximab was assessed in a single study,where the sole patient treated experienced a beneficial outcome.Additionally,a notable number of AIH cases were induced by anti-tumor necrosis factor(TNF)medications,including 16 cases associated with infliximab and four cases with adalimumab.All these cases showed improvement upon withdrawal of the biologic agent.CONCLUSION Belimumab and Rituximab show promise as effective alternatives for managing refractory AIH,demonstrating significant improvements in clinical outcomes and liver function.However,the variability in patient responses to different therapies highlights the need for personalized treatment strategies.The risk of AIH induced by anti-TNF therapies underscores the need for vigilant monitoring and prompt symptom recognition.These findings support the incorporation of biologic agents into AIH treatment protocols,particularly for patients who do not respond to conventional therapies.
文摘Background Induction therapy are utilized to achieve an adequate immunosuppression at the time of transplantation. The use of basiliximab or anti-thymocyte globulin （ATG） for induction therapy has significantly reduced the incidence of acute rejection episodes post-transplantation. The purpose of this study was to compare the efficacy and safety of the basiliximab in patients with immuno-induction therapy after kidney transplantation with the ATG. Methods A retrospective analysis was carried out in kidney transplant recipients including 146 patients with the basiliximab and 116 cases with the ATG and the acute rejection, graft function, infective complications and 1-year and 5-year actuarial patient and graft survival after renal transplantation were compared between the two treatment groups. Results There were no statistically significant difference between groups regarding age, sex, cold ischemic time, warm ischemic time, human leukocyte antigen （HLA） matching type between the donor and recipient, lymphotoxin test and the use of immunosuppressive agents. There was no statistical significance regarding the incidence of the acute rejection （9.59% vs. 8.62%, P=0.481） and delayed graft function （10.27% vs. 9.48%, P=0.501） between groups. There were significantly lower lung infection incidence （5.48% vs. 12.93%, P=0.029） in the basiliximab-treated group in comparison with the ATG-treated group. One-year patient and graft survival rates were 98%, 97% for the basiliximab-treated group, and 95%, 73% for the ATG-treated group, respectively. Five-year patient and graft survival rates were 92%, 86% for the basiliximab-treated group and 93%, 72% for the ATG-treated group, respectively. Log rank test showed statistically significant difference with P=0.038 for patients and P=-0.033 for grafts, respectively. There were significantly lower the incidence of granulocytopenia （8.22% vs. 17.24%, P=0.022） and thrombocytopenia （4.11% vs. 19.83%, P=0.000） after transplantation in the basiliximab-treated group in comparison with the ATG-treated group. There was no statistical significance regarding the incidence of the heart dysfunction after transplantation between the two groups （6.16% vs. 6.90%, P=0.502）. Conclusion The immuno-induction therapy with the basiliximab in kidney transplant recipients is efficient and safe with less complication compared with the ATG.
文摘目的:肝移植受者术后感染率高,识别出具有细菌与真菌感染高风险的患者将有利于预防疾病和改善肝移植受者的长期预后。本研究旨在了解肝移植术后早期(2个月内)细菌及真菌感染的病原菌组成、分布和预后,并分析其危险因素。方法:收集2020年5月至2021年10月在中南大学湘雅三医院行肝移植手术的受者发生细菌与真菌感染的病原体组成、分布和预后的数据,并分析感染发生的危险因素。结果:105例肝移植受者中75例发生了106株细菌或真菌感染,肝移植术后早期感染发生率为71.4%(75/105)。病原菌构成中G-杆菌处于优势(49/106,46.2%),G+球菌次之(31/106,29.2%)。G-杆菌中最常见者为鲍曼不动杆菌(13/106,12.3%)。G+球菌中最常见者为屎肠球菌(20/106,18.9%)。最常见感染部位为肺部感染(38/105,36.2%)及多部位感染(30/105,28.6%)。术后死亡6例(6/105,5.7%),均为感染患者。单因素分析显示术前终末期肝病模型(model for end stage liver disease,MELD)评分、术前半个月内抗生素使用、术前2个月内感染、术中红细胞输注量≥8 U、术后导尿管留置≥4 d及使用巴利昔单抗≥40 mg与感染发生有关;多元logistic回归分析显示仅术前两个月内感染(OR=5.172,95%CI:1.905~14.039,P<0.01)是肝移植术后细菌与真菌感染发生的独立危险因素,使用巴利昔单抗≥40 mg(OR=0.197,95%CI:0.051~0.762,P<0.05)的肝移植受者术后细菌与真菌感染率降低。结论:肝移植术后早期细菌与真菌感染发生率高,感染后病死率明显高于非感染患者,最常见感染部位为肺部,最多见病原体为G-杆菌。术前2个月内感染的受者术后易发生细菌与真菌感染。规范使用巴利昔单抗有助于减少肝移植术后感染的发生。
