Key result
Low-dose CNI plus ECP linked to less TTV viremia increase versus standard immunosuppression.
Why the study?
There is a need for surrogate markers of functional immune competence to tailor maintenance immunosuppressant dosing in adult orthotopic liver transplant recipients to minimize side effects and maximize graft survival.
Does a low-CNI + ECP immunosuppression protocol reduce TTV viremia compared to standard immunosuppression in adult orthotopic liver transplant recipients?
Comparison
Low-dose CNI plus extracorporeal photopheresis vs standard immunosuppression (CNI monotherapy or CNI + AZA/MMF)
Design
Observational cohort study reported in a letter format
Follow-up
12 months
Authors
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Supports TTV as surrogate for immunosuppression intensity in liver transplant; extends observational correlations to low-CNI + ECP but leaves clinical adoption open.
Does a low-CNI + ECP immunosuppression protocol reduce TTV viremia compared to standard immunosuppression in adult orthotopic liver transplant recipients?
p-value: p=<0.01
TTV viremia correlates with the intensity of maintenance immunosuppression in liver transplant recipients and may serve as a surrogate marker of functional immune competence.
Focosi et al. (2014) conducted a letter in Adult orthotopic liver transplant (n=111). Low-dose calcineurin inhibitors plus extracorporeal photopheresis (low-CNI + ECP) vs. Standard immunosuppression (CNI monotherapy or CNI + AZA/MMF) was evaluated on Increase in TTV viremia throughout the first posttransplant year (p=<0.01). Low-dose calcineurin inhibitors combined with extracorporeal photopheresis were associated with a significantly lower increase in TTV viremia compared to standard immunosuppressive protocols (P<0.01).
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