Safety and Efficacy of Everolimus Rescue Treatment After Pediatric Living Donor Liver Transplantation

Ueno, Takehisa; Kodama, Tasuku; Noguchi, Yuki; Deguchi, Koichi; Nomura, Motonari; Saka, Ryuta; Watanabe, Miho; Tazuke, Yuko; Bessho, Kazuhiko; Okuyama, Hiroomi

doi:https://doi.org/10.1016/j.transproceed.2020.01.159

Safety and Efficacy of Everolimus Rescue Treatment After Pediatric Living Donor Liver Transplantation

Ueno, Takehisa; Kodama, Tasuku; Noguchi, Yuki et al.

Transplantation Proceedings, 2020, 52(6), 1829-1832

Number of Access:952（2025-07-22 22:00 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/96477

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Title	Safety and Efficacy of Everolimus Rescue Treatment After Pediatric Living Donor Liver Transplantation
Creator	NRID 1000010456957 1000010456957 ORCID 0000-0002-4639-8814 0000-0002-4639-8814 researchmap permalink ueno-pedsurg ueno-pedsurg Scopus Author ID 21743992300 21743992300 CreatorName Ueno, Takehisa
	NRID 1000060771045 1000060771045 CreatorName Kodama, Tasuku
	NRID 1000030771042 1000030771042 CreatorName Noguchi, Yuki
	NRID 1000000747082 1000000747082 researchmap permalink deguchi_koichi deguchi_koichi Scopus Author ID 57139781700 57139781700 CreatorName Deguchi, Koichi
	NRID 1000040546909 1000040546909 researchmap permalink moto_pedsurg moto_pedsurg Scopus Author ID 35208741700 35208741700 ORCID 0009-0004-0959-7461 0009-0004-0959-7461 CreatorName Nomura, Motonari
	NRID 1000000459190 1000000459190 ORCID 0000-0001-8960-8618 0000-0001-8960-8618 researchmap permalink sakaryuta sakaryuta CreatorName Saka, Ryuta
	NRID 1000040791728 1000040791728 researchmap permalink miho miho Scopus Author ID 56282966800 56282966800 ORCID 0000-0001-6691-0611 0000-0001-6691-0611 CreatorName Watanabe, Miho
	NRID 1000010397698 1000010397698 researchmap permalink yukotazuke-osaka yukotazuke-osaka Scopus Author ID 7006109798 7006109798 ORCID 0000-0002-8335-0414 0000-0002-8335-0414 CreatorName Tazuke, Yuko
	NRID 1000080423169 1000080423169 researchmap permalink KazuBe KazuBe CreatorName Bessho, Kazuhiko
	NRID 1000030252670 1000030252670 researchmap permalink okuyamahiroomi okuyamahiroomi Scopus Author ID 35496082300 35496082300 ORCID 0000-0002-1347-282X 0000-0002-1347-282X CreatorName Okuyama, Hiroomi
Description	Ueno T., Kodama T., Noguchi Y., et al. Safety and Efficacy of Everolimus Rescue Treatment After Pediatric Living Donor Liver Transplantation. Transplantation Proceedings 52, 1829 (2020); https://doi.org/10.1016/j.transproceed.2020.01.159.
Abstract	Purpose: Everolimus (EVR) is a derivative of sirolimus with a similar mechanism of action. The safety and efficacy of EVR after pediatric living donor liver transplantation (LDLT) are currently unknown. The purpose of this study was to examine the safety and efficacy of EVR as rescue therapy after pediatric LDLT. Methods: This study included patients younger than 19 years of age who received EVR after LDLT at our institution. EVR was administered as rescue treatment in addition to tacrolimus. In 21 patients, EVR dose, trough level, outcomes, and adverse effects were assessed. Results: Original diseases of patients consisted of biliary atresia (n = 11), Alagille syndrome (n = 3), fulminant hepatitis (n = 3), hepatoblastoma (n = 2), and other (n = 2). Mean age at transplant was 2.0 years (range 0.6-6.2 years). Mean age at initial EVR administration was 8.0 years (range 0.9-18.9 years). Indications for EVR use were graft fibrosis (n = 8), refractory acute cellular rejection (n = 5), renal sparing (n = 4), hepatoblastoma (n = 2), and chronic rejection (CR) (n = 2). Mean duration of administration was 17.1 months (range 2.1-60.4 months). Mean dose was 0.5 mg/m2 twice daily. Mean EVR trough level was 2.5 ng/mL (range 1.5-5.0 ng/mL). Liver function improved and fibrosis did not progress in all patients with CR. However, 14 patients (67%) experienced adverse effects that required EVR dose reduction or discontinuation. Conclusion: EVR is tolerable for pediatric patients after LDLT with dose adjustment. EVR had a certain effect to relieve progression on CR. Further follow-up is required.
Publisher	Elsevier Inc.
Source Title	Transplantation Proceedings
Volume (Issue)	52(6)
Page	1829-1832
Date of Issued	2020-07-01
Language	English
Handle URL	https://hdl.handle.net/11094/96477
PISSN	00411345
eISSN	18732623
Relation.isVersionOf	DOI (Publisher Version) https://doi.org/10.1016/j.transproceed.2020.01.159
Access Rights	open access
CopyRight	© 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
oaire:version	Accepted Manuscript
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCTERMS.bibliographicCitation	Transplantation Proceedings. 2020, 52(6), p. 1829-1832
DC.title	Safety and Efficacy of Everolimus Rescue Treatment After Pediatric Living Donor Liver Transplantation
DC.creator	Ueno, Takehisa
	Kodama, Tasuku
	Noguchi, Yuki
	Deguchi, Koichi
	Nomura, Motonari
	Saka, Ryuta
	Watanabe, Miho
	Tazuke, Yuko
	Bessho, Kazuhiko
	Okuyama, Hiroomi
DC.publisher	Elsevier Inc.
DC.language' scheme='DCTERMS.RFC1766	English
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2020-07-01
DC.identifier	https://doi.org/10.1016/j.transproceed.2020.01.159
DC.description	Ueno T., Kodama T., Noguchi Y., et al. Safety and Efficacy of Everolimus Rescue Treatment After Pediatric Living Donor Liver Transplantation. Transplantation Proceedings 52, 1829 (2020); https://doi.org/10.1016/j.transproceed.2020.01.159.
DCTERMS.abstract	Purpose: Everolimus (EVR) is a derivative of sirolimus with a similar mechanism of action. The safety and efficacy of EVR after pediatric living donor liver transplantation (LDLT) are currently unknown. The purpose of this study was to examine the safety and efficacy of EVR as rescue therapy after pediatric LDLT. Methods: This study included patients younger than 19 years of age who received EVR after LDLT at our institution. EVR was administered as rescue treatment in addition to tacrolimus. In 21 patients, EVR dose, trough level, outcomes, and adverse effects were assessed. Results: Original diseases of patients consisted of biliary atresia (n = 11), Alagille syndrome (n = 3), fulminant hepatitis (n = 3), hepatoblastoma (n = 2), and other (n = 2). Mean age at transplant was 2.0 years (range 0.6-6.2 years). Mean age at initial EVR administration was 8.0 years (range 0.9-18.9 years). Indications for EVR use were graft fibrosis (n = 8), refractory acute cellular rejection (n = 5), renal sparing (n = 4), hepatoblastoma (n = 2), and chronic rejection (CR) (n = 2). Mean duration of administration was 17.1 months (range 2.1-60.4 months). Mean dose was 0.5 mg/m2 twice daily. Mean EVR trough level was 2.5 ng/mL (range 1.5-5.0 ng/mL). Liver function improved and fibrosis did not progress in all patients with CR. However, 14 patients (67%) experienced adverse effects that required EVR dose reduction or discontinuation. Conclusion: EVR is tolerable for pediatric patients after LDLT with dose adjustment. EVR had a certain effect to relieve progression on CR. Further follow-up is required.
DC.rights	© 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
DC.format	96477
citation_title	Safety and Efficacy of Everolimus Rescue Treatment After Pediatric Living Donor Liver Transplantation
citation_author	Ueno, Takehisa
	Kodama, Tasuku
	Noguchi, Yuki
	Deguchi, Koichi
	Nomura, Motonari
	Saka, Ryuta
	Watanabe, Miho
	Tazuke, Yuko
	Bessho, Kazuhiko
	Okuyama, Hiroomi
citation_publisher	Elsevier Inc.
citation_language	English
citation_date	2020-07-01
citation_journal_title	Transplantation Proceedings
citation_volume	52
citation_issue	6
citation_firstpage	1829
citation_lastpage	1832
citation_doi	https://doi.org/10.1016/j.transproceed.2020.01.159
citation_public_url	https://hdl.handle.net/11094/96477

Safety and Efficacy of Everolimus Rescue Treatment After Pediatric Living Donor Liver Transplantation

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