Evidence that ursodeoxycholic acid prevents steroid-resistant rejection in adult liver transplantation

Pierre A. Clavien, Ala I. Sharara, Carlos A. Camargo, Robert C. Harland, J. Gregory Fitz

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Steroid-resistant rejection continues to be a serious problem in liver transplantation. Since ursodeoxycholic acid (UDCA) is beneficial in several cholestatic disorders and possesses in vitro immunomodulatory and immunosuppressive effects, we have tested in a pilot study the effects of adjuvant UDCA in the prevention of steroid-resistant rejection. Fifty consecutive liver transplant patients were treated with a standard cyclosporine immunosuppressive regimen. Treatment with UDCA (10 mg/kg/d) was initiated in each patient who developed biopsy-proven rejection or biochemical evidence of cholestasis. Clinical and laboratory features were monitored for evidence of rejection. Data were analyzed after at least a 10-month follow-up period was available in each patient. Seven patients died during the study period, all within 4 wk of surgery. No evidence of rejection was documented in these patients. Twenty three of the 43 survivors 53% (23/43) developed an episode of rejection, and UDCA was initiated in each of them. Only one patient had,a second episode of rejection, which responded to intravenous methylprednisolone therapy; no patient required antilymphocyte therapy. There was no evidence of toxicity for UDCA. These data suggest that UDCA can be given safely following OLT and may contribute to prevention of steroid-resistant rejection in liver transplant recipients.

Original languageEnglish (US)
Pages (from-to)658-662
Number of pages5
JournalClinical Transplantation
Volume10
Issue number6 II
StatePublished - Dec 1 1996

Keywords

  • Cost
  • Liver transplantation
  • Pilot study
  • Prophylaxis
  • Rejection
  • Ursodeoxycholic acid

ASJC Scopus subject areas

  • Transplantation

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  • Cite this

    Clavien, P. A., Sharara, A. I., Camargo, C. A., Harland, R. C., & Fitz, J. G. (1996). Evidence that ursodeoxycholic acid prevents steroid-resistant rejection in adult liver transplantation. Clinical Transplantation, 10(6 II), 658-662.