Evidence map›Paper›PMID 34557582›Full record

ArticleTransplantation direct2021

Long-term Follow-up of a Randomized Trial of Tacrolimus or Cyclosporine A Microemulsion in Children Post Liver Transplantation.

Carla Lloyd, Adam Arshad, Paloma Jara, Martin Burdelski, Bruno Gridelli, J Manzanares, Michele Colledan, Emmanuel Jacquemin, Raymond Reding, Ulrich Baumann and 1 more

Open access · goldAbstract read
In one paragraph

Article in Transplantation direct, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.4field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 4 countries.

Carla LloydLiver Unit, Birmingham Women's and Children's Hospital, Birmingham, United Kingdom.
Adam ArshadLiver Unit, Birmingham Women's and Children's Hospital, Birmingham, United Kingdom.
Paloma JaraDepartment of Paediatric Hepatology, Hospital Infantil La Paz, Madrid, Spain.
Martin BurdelskiPädiatrische Gastroenterologie, Kinderklinik, Universitätskrankenhaus Eppendorf, Hamburg, Germany.
Bruno GridelliChirurgia Generale III, Centro Trapiantodi Fegato Pediatrico, Ospedale Riunti di Bergamo, Bergamo, Italy.
J ManzanaresServicio de Gastroenterologia, Hospital Materno-Infantil Doce de Octubre, Madrid, Spain.
Michele ColledanDepartment of Surgery, Ospedale Papa Giovanni XXIII, Bergamo, Italy.
Emmanuel JacqueminPediatric Hepatology and Liver Transplantation Unit, Bicêtre Hospital, Assistance Publique - Hôpitaux de Paris, University Paris-Saclay, Paris, France.
Raymond RedingPaediatric Liver Transplantation Program, Cliniques Universitaires Saint-Luc, Department de Chirurgie, Université Catholique de Louvain, Brussels, Belgium.
Ulrich BaumannDepartment of Paediatric Gastroenterology and Hepatology, Hanover Medical School, Hanover, Germany.
Deirdre KellyLiver Unit, Birmingham Women's and Children's Hospital, Birmingham, United Kingdom.
Charité - Universitätsmedizin Berlin · DEHospital Materno-Infantil · ESHospital Universitario La Paz · ESOspedale Papa Giovanni XXIII · ITUCLouvain · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The aim of this study was to determine the long-term efficacy and safety of tacrolimus (Tac) and cyclosporine immunosuppression in pediatric liver transplantation (LTx).

methodsOne hundred fifty-six patients who had taken part in a multicenter, randomized, open, parallel study of Tac and corticosteroids versus cyclosporine A microemulsion (CyA-ME), corticosteroids, and azathioprine. Patients were assessed at regular intervals up to 14 y after LTx. Analysis was conducted descriptively.

resultsIn a long-term follow-up, there was a similar incidence of acute rejection (Tac versus CyA-ME, 5 versus 8) and graft loss (5 versus 10). There were 11 deaths in the cohort, which were from infectious complications/malignancy in the Tac group (n = 2/5) and from chronic rejection/liver failure in the CyA-ME group (n = 3/6). A similar incidence of Epstein-Barr virus and posttransplant lymphoproliferative disease was observed (8 versus 8, 3 versus 3). However, there was a greater incidence of cosmetic adverse events in the CyA-ME cohort, with higher incidences of hypertrichosis (8 versus 27) and gum hyperplasia (20 versus 6). Growth improved equally in both groups. Overall, 81% of patients randomized to Tac remained on Tac therapy at study end, compared with 31% of patients randomized to CyA-ME. Common reasons for switching from CyA-ME included steroid-resistant/acute rejection (n = 12/8) and cosmetic changes (n = 8).

conclusionsThis study is the first prospective, observational follow-up study of pediatric patients randomized to Tac and CyA-ME to evaluate long-term outcomes. Our analysis was limited by the degree of switchover between the cohorts; however, there were fewer deaths from chronic rejection/liver failure and reduced adverse events with Tac. Long-term use of Tac and Tac combination therapy appears to be safe and effective immunosuppression for pediatric LTx recipients.

Identifiers

PMID34557582
PMCPMC8454910
OpenAlexW3201447438

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.