Role of Budesonide for the Treatment of Rejection in Pediatric Liver Transplantation

Corticosteroids are an essential component of liver transplant (LT) immunosuppressive regimens, although they are frequently associated with a slew of side effects. Budesonide is an oral corticosteroid that is extensively metabolized in the liver and has little systemic absorption. The purpose of this study was to look into the safety and effectiveness of budesonide in the treatment of acute cellular rejection (ACR) in juvenile LT recipients. All pediatric patients who had LT at our center and were administered oral budesonide for the treatment of ACR were subjected to a retrospective descriptive study. Alanine aminotransferase (ALT) levels and reported side effects were examined. Budesonide was administered to 29 individuals for the treatment of ACR, with 65.5 percent having biopsy-proven acute rejection and 34.5 percent having suspected ACR. When compared to readings 1 month, 3 months, and 6 months following budesonide therapy, there was a substantial reduction in ALT from the time of rejection. There was no difference in patient baseline ALT levels before rejection as compared to 1, 3, and 6 months post treatment values, indicating rejection resolution. Three patients needed to be switched from budesonide to systemic steroids. There were no budesonide discontinuations due to side effects.

Oral budesonide may be a potential option to systemic corticosteroids for the treatment of mild/moderate ACR, as well as for the treatment of ACR in certain pediatric LT patients. The findings of this investigation might provide the groundwork for bigger, prospective, multicenter trials to evaluate the efficacy of budesonide in the treatment of ACR.

Reference: https://journals.lww.com/jpgn/Abstract/2020/09000/Role_of_Budesonide_for_the_Treatment_of_Rejection.19.aspx



source https://www.physiciansweekly.com/role-of-budesonide-for-the-treatment-of-rejection-in-pediatric-liver-transplantation/

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