Nav: Home

University of Cincinnati finds new option for liver transplant patients

November 08, 2019

CINCINNATI--A drug commonly used to treat both asthma and inflammatory bowel disease, budesonide, may also be useful as an anti-organ rejection medication for liver transplant patients leading to fewer serious side effects than the most commonly used therapy, according to a University of Cincinnati researcher.

Dr. Khurram Bari, an associate professor in the UC Division of Digestive Diseases, explains the drug was given to 20 liver transplantation patients over a 12-week period, and researchers found that organ rejection rates were identical to patients who received prednisone, which is considered the gold standard for treating liver transplantation patients.

Bari cautions the findings are preliminary and involve a small sample size. He will present his research at the annual meeting of the American Association for the Study of Liver Diseases in Boston scheduled for November 8-12.

"There are a few medications we use for immune suppression during liver transplantation and prednisone is one of them," said Bari, a physician at UC Health, the health system affiliated with the UC College of Medicine. "We use it during the first three to six months to prevent rejection, but there are side effects."

Nationally, about 18,000 patients are in need of a liver transplant, he says. In 2018, UC Medical Center performed 115 liver transplants, according to Bari.

"Prednisone can trigger new onset diabetes and loss of bone density," said Bari. "Lots of studies have looked at whether we can exclude prednisone totally. It is needed, but there are a lot of side effects. I wanted to use something in place of prednisone which might be less toxic."

There were equal immune suppression rates for budesonide and prednisone, but the rates of infections in patients with budesonide were lower, according to Bari. Also, the rates of new onset diabetes in patients with budesonide were lower than patients treated with prednisone.

"This is a very small study, so we could not randomize the patients," said Bari. "We just gave budesonide to 20 patients and matched them with a control group, which received standard treatment with prednisone. My goal is to do a bigger study where we would randomize these patients with prednisone."

The pilot study was funded by the American College of Gastroenterology and the UC Center for Clinical Translational Science and Training (CCTST). Funded by UC and Cincinnati Children's Hospital Medical Center, the CCTST provides services and support in several core program areas, advancing innovation in clinical and translational science and training.

Bari said the U.S. Food and Drug Administration approved budesonide for oral use to treat Crohn's disease and ulcerative colitis. It can be administered via inhaler to treat asthma.

Bari said longer term use of prednisone can also lead to kidney dysfunction and cardiovascular problems, cancers and metabolic events in patients.

"Prednisone impacts the ability of the adrenal glands to make cortisol, the body's main stress hormone, which controls your mood, motivation and fear instincts and also plays a role in regulating blood pressure," said Bari.

"Organ rejection is something but the risk goes lower and lower with time as the body gets used to the organ," said Bari.

Liver transplantation patients on average have a 92% survival rate one year after surgery, said Bari. A decade later the survival rate remains near 65%, he said.
-end-
Other co-investigators on the study include Dr. Kenneth Sherman, director and professor in the UC Division of Digestive Diseases; Dr. Shimul Shah, professor in the UC Department of Surgery; Dr. Robert Cohen, professor in the UC Division of Endocrinology, Diabetes and Metabolism; Dr. Nadeem Anwar, professor in the UC Division of Digestive Diseases; Tiffany Kaiser, research associate professor in the UC Division of Digestive Diseases; and Dr. David Kleesattel, UC Department of Internal Medicine.

University of Cincinnati

Related Liver Transplant Articles:

Advanced liver disease patients and transplant recipients need specific care during COVID-19
The European Association for the Study of the Liver (EASL) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) have issued a Position Paper, providing recommendations for clinicians caring for patients with liver diseases during the current pandemic.
Certain liver cells may help prevent organ rejection after transplant, study finds
Mesenchymal stromal cells from fat tissue and bone marrow are widely used in therapeutic trials for their anti-inflammatory qualities, but new Mayo Clinic research finds that liver cells may be of greater value.
University of Cincinnati finds new option for liver transplant patients
Budesonide, a drug commonly used to treat Crohn's Disease, may offer fewer side effects and work at least as well as prednisone as an anti-organ rejection medication in liver transplant patients.
Cleveland clinic's first purely laparoscopic living donor surgery for liver transplant
Cleveland Clinic has successfully performed the Midwest's first purely laparoscopic living donor surgery for liver transplantation in an adult recipient.
Alcohol relapse rate among liver transplant recipients identical regardless of sobriety period
For decades, patients with liver disease related to alcohol use have been told they must be sober for six months before they can get a liver transplant.
Why liver transplant waitlists might misclassify high-risk patients
A new study in the journal Gastroenterology reveals that the standard method for ranking patients on the waitlist for lifesaving liver transplantation may not prioritize some of the sickest candidates for the top of the list.
Liver transplant for alcohol-related liver disease in US
The proportion of liver transplants in the United States for alcohol-associated liver disease increased between 2002 and 2016, with much of the increase associated with a decrease in liver transplant for hepatitis C virus infection because of antiviral therapy.
African-Americans may live longer after liver transplant if their donors are the same race
African-American adults undergoing liver transplant to treat liver cancer lived significantly longer if their organ donor was also African-American.
Liver transplant survival rate sees improvement among older adults
To learn more about older adults and liver transplants, a team of researchers studied information recorded by the Scientific Registry of Transplant Recipients (SRTR) from 2003 to 2016.
Anticancer drug offers potential alternative to transplant for patients with liver failure
Patients suffering sudden liver failure could in the future benefit from a new treatment that could reduce the need for transplants, research published today shows.
More Liver Transplant News and Liver Transplant Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Teaching For Better Humans 2.0
More than test scores or good grades–what do kids need for the future? This hour, TED speakers explore how to help children grow into better humans, both during and after this time of crisis. Guests include educators Richard Culatta and Liz Kleinrock, psychologist Thomas Curran, and writer Jacqueline Woodson.
Now Playing: Science for the People

#556 The Power of Friendship
It's 2020 and times are tough. Maybe some of us are learning about social distancing the hard way. Maybe we just are all a little anxious. No matter what, we could probably use a friend. But what is a friend, exactly? And why do we need them so much? This week host Bethany Brookshire speaks with Lydia Denworth, author of the new book "Friendship: The Evolution, Biology, and Extraordinary Power of Life's Fundamental Bond". This episode is hosted by Bethany Brookshire, science writer from Science News.
Now Playing: Radiolab

Dispatch 3: Shared Immunity
More than a million people have caught Covid-19, and tens of thousands have died. But thousands more have survived and recovered. A week or so ago (aka, what feels like ten years in corona time) producer Molly Webster learned that many of those survivors possess a kind of superpower: antibodies trained to fight the virus. Not only that, they might be able to pass this power on to the people who are sick with corona, and still in the fight. Today we have the story of an experimental treatment that's popping up all over the country: convalescent plasma transfusion, a century-old procedure that some say may become one of our best weapons against this devastating, new disease.   If you have recovered from Covid-19 and want to donate plasma, national and local donation registries are gearing up to collect blood.  To sign up with the American Red Cross, a national organization that works in local communities, head here.  To find out more about the The National COVID-19 Convalescent Plasma Project, which we spoke about in our episode, including information on clinical trials or plasma donation projects in your community, go here.  And if you are in the greater New York City area, and want to donate convalescent plasma, head over to the New York Blood Center to sign up. Or, register with specific NYC hospitals here.   If you are sick with Covid-19, and are interested in participating in a clinical trial, or are looking for a plasma donor match, check in with your local hospital, university, or blood center for more; you can also find more information on trials at The National COVID-19 Convalescent Plasma Project. And lastly, Tatiana Prowell's tweet that tipped us off is here. This episode was reported by Molly Webster and produced by Pat Walters. Special thanks to Drs. Evan Bloch and Tim Byun, as well as the Albert Einstein College of Medicine.  Support Radiolab today at Radiolab.org/donate.