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News Releases

For Immediate Release

Children’s Hospital of Pittsburgh Dramatically Improves Organ Transplant Outcomes by Eliminating Steroids

Children’s successes have led to a record number of intestine transplants this year

Transplant surgeons at Children’s Hospital of Pittsburgh have made unprecedented advancements over the last year in the use of immunosuppressive therapy to prevent rejection following pediatric liver and intestine transplants.

Surgeons at Children’s have been able to successfully wean patients off anti-rejection medications without the use of steroids, which for decades have been used as standard treatment to prevent rejection following transplant surgery at centers throughout the world.

“For the first time, we’ve eliminated steroids for these patients and it has dramatically decreased the incidence of rejection, the severity of rejection and allowed us to minimize post-transplant immunosuppression early on,” said Jorge Reyes, MD, director of pediatric transplantation at Children’s. “Eliminating steroids has made a major difference in how these patients feel and it will positively impact their development and ability to function as adults.”

Children’s pioneering approaches to organ transplant has led to several milestones for the liver/intestine transplant program in 2003.

In February, surgeons at Children’s performed the 100th intestine transplant since 1990 and already in 2003 have performed 25 liver/intestine and intestine transplants, more than any other pediatric transplant center in the United States, according to the United Network for Organ Sharing. This represents a record number for Children’s and makes up more than one-third of all intestine transplants performed nationwide in children this year.

More than 50 patients have received liver, liver/intestine and intestine transplants at Children’s in the last year without the use of steroids. Under the new protocol, instead of receiving the anti-rejection medication tacrolimus twice a day and steroids up to 10 times a day, patients receive only one daily dose of tacrolimus, as well as another anti-rejection medication called thymoglobulin, given before and after transplant.

The survival rates so far with this new protocol - developed at Children’s by Dr. Reyes in collaboration with University of Pittsburgh transplant pioneer Thomas E. Starzl, MD - are 100 percent for intestine transplants and 93 percent for liver transplants. This compares with a national one-year survival rate of approximately 70 percent for intestinal transplants and approximately 85 percent for liver transplants.

This new approach allows transplant surgeons at Children’s to better control patients’ blood pressure, fluid accumulation and hypertension. Because of this, hospital stays are shorter and complications from transplant are fewer.

As recently as a decade ago, intestine transplants were considered prohibitive because of the extremely high incidence of rejection. The overall historical intestinal survival rate internationally has been about 45 percent.

Organ transplantation requires suppression of the recipient’s immune system to prevent rejection. Transplant surgeons had previously felt that the more you suppressed a recipient’s immune system, the better the outcome, according to Dr. Reyes.

“Now, we’re realizing less is better,” he said. “Not only is steroid-free immunosuppression leading to better outcomes and fewer complications, it also improves the quality of life for these young patients. Rather than taking up to 10 pills a day, now they may take only one.”

These accomplishments build upon Children’s reputation as an international leader in pediatric transplantation.

Under the guidance of Dr. Starzl, Children’s established the first pediatric transplant center in the world in 1981. Since then, Children’s surgeons have performed more transplants on kids than any other center in the world.

In addition to performing more than 1,000 pediatric liver transplants, Children’s transplant surgeons also:

  • performed the world’s first pediatric heart/lung transplant.
  • performed the world’s first pediatric double lung transplant.
  • performed more than 250 thoracic organ transplants in children.
  • performed more pediatric heart/lung transplants than any other center in the country.

Contacts:
Marc Lukasiak, 412-692-5016, Marc.Lukasiak@chp.edu
Melanie Finnigan, 412-692-5016, Melanie.Finnigan@chp.edu

Last Update
February 19, 2008
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Last Update
February 19, 2008
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