Interleukin-2 receptor antagonists for pediatric liver transplant recipients: A systematic review and meta-analysis of controlled studies

IL‐2RA are frequently used as induction therapy in liver transplant recipients to decrease the risk of AR while allowing the reduction of concomitant immunosuppression. The exact association with the use of IL‐2RA, however, is uncertain. We performed a systematic literature search for relevant studi...

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Bibliographic Details
Published in:Pediatric transplantation 2014-12, Vol.18 (8), p.839-850
Main Authors: Crins, Nicola D., Röver, Christian, Goralczyk, Armin D., Friede, Tim
Format: Article
Language:English
Subjects:
Antibodies, Monoclonal - therapeutic use
Antibodies, Monoclonal, Humanized - therapeutic use
basiliximab
Child
Controlled Clinical Trials as Topic
controlled study
daclizumab
Graft Rejection - prevention & control
Graft Survival
Humans
Immunoglobulin G - therapeutic use
immunosuppression
Immunosuppressive Agents - therapeutic use
interleukin-2 receptor antagonist
Liver Transplantation
meta-analysis
Models, Statistical
pediatric
Receptors, Interleukin-2 - antagonists & inhibitors
Recombinant Fusion Proteins - therapeutic use
Treatment Outcome
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Summary:IL‐2RA are frequently used as induction therapy in liver transplant recipients to decrease the risk of AR while allowing the reduction of concomitant immunosuppression. The exact association with the use of IL‐2RA, however, is uncertain. We performed a systematic literature search for relevant studies. Random effects models were used to assess the incidence of AR, steroid‐resistant rejection, graft loss, patient death, and adverse drug reaction, with or without IL‐2RA. Six studies (two randomized and four non‐randomized) met the eligibility criteria. Acute rejection at six months or later favored the use of IL‐2RA significantly (RR 0.38; 95% CI 0.22–0.66, p = 0.0005). Although not statistically significant, IL‐2RA showed a substantial reduction of the risk of steroid‐resistant rejection (RR 0.32; CI 0.19–1.03, p = 0.0594). Graft loss and patient death showed a reductive tendency through the use of IL‐2RA. The use of IL‐2RA is safe and is associated with a statistically significantly lower incidence of AR after transplantation and substantial reduction of steroid‐resistant rejection, graft loss, and patient death.
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.12362