Tohoku J. Exp. Med., 2006, 208(3)

Usage of Deoxyspergualin on Steroid-Resistant Acute
Rejection in Living Donor Liver Transplantation

NAOKI KAWAGISHI, KAZUSHIGE SATOH, YOSHITAKA ENOMOTO, YORIHIRO AKAMATSU, SATOSHI SEKIGUCHI and SUSUMU SATOMI

Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Sendai, Japan

Deoxyspergualin (DSG) is an immunosuppressive agent used to treat steroid-resistant acute rejection after kidney transplantation. But in the case of acute rejection after liver transplantation, DSG was reported effective in just a few cases. From July 1991 to November 2005, 96 patients underwent living donor liver transplantation (LDLTx) in our institution. Of them, 9 patients, including 4 ABO incompatible recipients, are presented. Rejection symptoms that did not respond to steroid pulse therapy (methylprednisolone, 10-20 mg/kg/day for 3 days) and were treated with DSG (3 or 5 mg/kg/day) for 4 to 14 days together with a maintenance dose of the steroid. Among them, five responded to treatment with DSG, two did not respond and the other two patients were not evaluated. Six of the nine patients are symptom free at present. Complications such as leukopenia and thrombocytopenia were successfully treated with granulocyte-colony stimulating factor or by platelet transfusion. No recipient died as a direct consequence of the complications induced by DSG. DSG proved effective and safe for some of the LDLTx recipients with steroid-resistant acute rejection but it was not effective for the treatment of accelerated humoral rejection in ABO incompatible recipients.

keywords —— liver transplantation; living donor; deoxyspergualin (DSG); rejection; ABO incompatibility

© 2006 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2006, 208, 225-233

Received November 22, 2005; revision accepted for publication December 27, 2005.
Correspondence: Naoki Kawagishi, Division Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, 1-1 Seiryomachi, Aoba-ku, Sendai 980-8574, Japan.

e-mail:kawan@mail.tains.tohoku.ac.jp