***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This r and omized , prospect i ve , multicenter trial compared the safety and efficacy of steroid-free immunosuppression ( IS ) to the safety and efficacy of 2 st and ard IS regimens in patients undergoing transplantation for hepatitis C virus ( HCV ) infection . The outcome measures were acute cellular rejection ( ACR ) , severe HCV recurrence , and survival .  The patients were r and omized ( 1:1:2 ) to tacrolimus ( TAC ) and corticosteroids ( arm 1 ; n = 77 ) , mycophenolate mofetil ( MMF ) , TAC , and corticosteroids ( arm 2 ; n = 72 ) , or  MMF , TAC , and daclizumab induction with no corticosteroids  ( arm 3 ; n = 146 ) . In all , 295 HCV RNA-positive subjects were enrolled . At 2 years , there were no differences in ACR , HCV recurrence ( biochemical evidence ) , patient survival , or graft survival rates . The side effects of IS did not differ , although there was a trend toward less diabetes in the steroid-free group . Liver biopsy sample s revealed no significant differences in the proportions of patients in arms 1 , 2 , and 3 with advanced HCV recurrence ( ie , an inflammation grade ≥ 3 and /or a fibrosis stage ≥ 2 ) in years 1 ( 48.2 % , 50.4 % , and 43.0 % , respectively ) and 2 ( 69.5 % , 75.9 % , and 68.1 % , respectively ) . Although we have found that steroid-free IS is safe and effective for liver transplant recipients with chronic HCV , steroid sparing has no clear advantage in comparison with traditional IS The immunosuppressive effect of a monoclonal antibody ( moAb ) , BT563 , directed to the alpha-chain of the IL-2R ( CD25 ) , was analyzed in a prospect i ve nonr and omized trial and a prospect i ve r and omized trial . Primary objectives were evaluation of the incidence of acute rejections and infections ; secondary objectives were safety and tolerability of the moAb . A total of 28 patients were enrolled ( phase II ) to receive 10 mg/day of BT563 ( 12 days ) as immunoprophylaxis in combination with cyclosporine , azathioprine , and low-dose steroids .  Subsequently 32 patients were r and omly assigned ( phase III ) to receive BT563 ( 10 mg/day ) for 12 days or ATG ( 5 mg/kg/day ) for 7 days in addition to cyclosporine and low-dose steroids . No side effects of the BT563 treatment were noted . The actuarial survival was 82 % at 12 months in the phase II trial and 92 % at 12 months in both arms of the phase III trial . There was one acute rejection in the phase II trial . No acute rejections were noted in the BT arm of the phase III trial and 5 acute rejections were treated in the ATG arm . In the phase II trial 7 infectious episodes were observed , while one infection was seen in the BT arm and 7 in the ATG arm of the triple immunosuppression phase III trial . In all patients circulation of coated CD25 + lymphocytes was observed during BT563 treatment ; there was no evidence of depletion or modulation of CD25 + cells . Mean serum levels of BT563 ranged from 1.6 to 7.6 microgram/ml throughout the therapy . An antimurine response was seen in 82 % ( phase II ) and 100 % ( phase III ) of the patients . Antirabbit antibodies were found in 56 % of the patients treated with ATG . Analysis of the antimurine response specificity revealed in 56 % blocking anti-isotypic antibodies and only in 3 % of the patients an anti-idiotypic response . The data of the study presented suggest that therapy with an anti IL-2R moAb is at least equal to ATG application according to the incidence of acute rejections and infections Basiliximab , a high-affinity chimeric monoclonal antibody , is effective in reducing acute rejection episodes in renal allograft recipients . We assessed the ability of this antibody to similarly improve the outcome in liver transplant recipients . Adult recipients of a primary cadaveric liver transplant were r and omized to treatment , stratified by hepatitis C virus ( HCV ) seropositivity . Patients were administered 40 mg of basiliximab  ( n = 188 ) or placebo ( n = 193 ) as two 20-mg bolus injections days 0 and 4 , plus cyclosporine and steroids . Primary efficacy variables were biopsy-confirmed acute rejection and its composite end point , including death or graft loss , and were assessed at 6 and 12 months and by HCV cohort . Because of differential efficacy responses between HCV-positive and HCV-negative cohorts , an additional analysis incorporating HCV recurrence as a component of treatment failure , termed problem-free transplant , was introduced . Safety and tolerability were monitored over the 12 months of the study . All 381 patients were assessable , and no meaningful differences in background characteristics were apparent between treatment groups . Biopsy-confirmed acute rejection rates 6 months after transplantation were 35.1 % in the basiliximab group versus 43.5 % in the placebo group . For death , graft loss , or first biopsy-confirmed acute rejection , rates were 44.1 % versus 52.8 % , respectively . The reduction in rejection episodes was concentrated in the HCV-negative cohort ( 14.5 % relative to placebo ; P = .034 ) , with a much smaller difference ( 2.9 % ) in the HCV-positive cohort . For HCV-positive patients , problem-free transplant was shown at 12 months in 26.6 % of the basiliximab group versus 11.6 % in the placebo group ( P = .020 ) and for all patients at 12 months in 39.7 % of the basiliximab group versus 30.1 % in the placebo group ( P = .035 ) . The incidence of infection and other adverse events was similar across the two treatment groups . There were 56 deaths ( 25 deaths , basiliximab group ; 31 deaths , placebo group ) over the 12-month study . The intravenous bolus injection was well tolerated . Immunoprophylaxis with 40 mg of basiliximab , in combination with cyclosporine and steroids , reduces the incidence of acute rejection episodes with no clinical ly relevant safety or tolerability concerns . The influence of HCV recurrence on efficacy results can be accounted for in future trials by using the concept of problem-free transplant , incorporating recurrence as a component of treatment failure A multiinstitutional r and omized trial was undertaken comparing OKT3 with steroids for treatment of  hepatic allograft rejection . All patients received baseline immunosuppression with Cyclosporine ( CsA ) and steroids . At the time of biopsy-confirmed rejection , up to 2 intravenous boluses ( 250–1000 mg ) of methylprednisolone were initially administered . Twenty-eight patients who failed to respond were then r and omly assigned to OKT3 or continued steroid therapy . Rescue therapy with the opposite treatment arm was added after 6 days if the primarily allocated protocol failed . Three of 13 patients assigned to the steroid group responded promptly , and continue with good function 7–12 months later . OKT3 rescue was required in 10 patients who failed to improve despite receiving up to 6 g of methylprednisolone ( mean : 3.3 g/patient ) . One patient died of sepsis and hepatic failure . Rejection was reversed in 9 OKT3-rescue patients , 7 of whom are well 1–17 months later . In the OKT3 group , improved allograft function was observed within 72 hr in 11 of 15 patients . Two patients with inadequate response were successfully rescued with steroids ; 1 patient underwent retransplantation ; and 1 patient developed a biliary fistula that eventually result ed in sepsis and death . In summary , 23 of 28 hepatic recipients ( 82 % ) are alive with the original allograft 1–17 ( mean 7.8 ) months after treatment for acute rejection . Another patient is alive 14 months following retransplantation . Eighteen ( 78 % ) of the survivors required OKT3 as initial ( 11 ) or rescue ( 7 ) therapy , whereas only 5 were successfully managed with steroids . OKT3 is superior to steroids for reversing liver allograft rejection and has greatly reduced the need for retransplantation even in recipients selected on the basis of having failed initial steroid therapy Background . Calcineurin inhibitor-induced renal dysfunction is a major problem in liver transplantation . Interleukin-2 receptor antagonist induction followed by delayed tacrolimus ( Tac ) administration may minimize the renal insult without compromising immunoprotection . Methods . This open , r and omized , multicenter trial evaluated the benefit of daclizumab induction with delayed Tac on renal function at 6 months ; an observational study was continued for 18 months . Liver transplant patients with a 12-hr serum creatinine ( SrC ) level less than 180 & mgr;mol/L received either delayed Tac with daclizumab induction ( n=98 ) or st and ard Tac ( n=101 ) both combined with mycophenolate mofetil and steroids . The primary endpoint was the incidence of SrC level more than 130 & mgr;mmol/L at 6 months . Results . The incidence was 22.4 % with delayed Tac and 29.7 % with st and ard Tac ( P = ns ) , which remained unchanged at 12 months ( 21.6 % and 23.9 % ) but increasing slightly at 24 months ( 29.0 % and 32.9 % ) , respectively . A post hoc analysis of renal function was done based on patients stratification by SrC at 12 hr ( ≤100&mgr;mol/L or > 100 & mgr;mol/L ) showing no difference in SrC values at 6 months regardless of the 12-hr values despite a trend toward better estimated glomerular filtration rate for patients with 12-hr value less than 100 & mgr;mol/L in the delayed Tac group . Biopsy-proven acute rejection was similar at 6 months ( 17.5 % and 18.75 % ) , 12 months ( 23.5 % and 23.8 % ) , and 24 months ( 24.5 % and 25.7 % ) , respectively . Patient and graft survival in both groups were comparable and good . Similar types and incidences of adverse events were reported in both groups at all time . Conclusions . Delay of Tac does not benefit renal function in liver transplant recipients with a good renal function at baseline OBJECTIVES To analyze sources search ed in Cochrane review s , to determine the proportion of trials included in review s that are indexed in major data bases , and to compare the quality of these trials with those from other sources . METHODS All new systematic review s in the Cochrane Library , Issue1 2001 , that were restricted to r and omized controlled trials ( RCTs ) or quasi- RCTs were selected . The sources search ed in the review s were recorded , and the trials included were checked to see whether they were indexed in four major data bases . Trials not indexed were checked to determine how they could be identified . The quality of trials found in major data bases was compared with those found from other sources . RESULTS The range in the number of data bases search ed per review ranged between one and twenty-seven . The proportion of the trials in the four data bases were Cochrane Controlled Trials Register = 78.5 % , MEDLINE = 68.8 % , Embase = 65.0 % , and Science/Social Sciences Citation Index = 60.7 % . Search ing another twenty-six data bases after Cochrane Controlled Trials Register ( CCTR ) , MEDLINE , and Embase only found 2.4 % additional trials . There was no significant difference between trials found in the CCTR , MEDLINE , and Embase compared with other trials , with respect to adequate allocation concealment or sample size . CONCLUSIONS There was a large variation between review s in the exhaustiveness of the literature search es . CCTR was the single best source of RCTs . Additional data base search ing retrieved only a small percentage of extra trials . Contacting authors and manufacturers to find unpublished trials appeared to be a more effective method of obtaining the additional better quality trials It has been shown that an induction therapy with the monoclonal anti-interleukin-2 receptor antibody basiliximab ( Simulect ) is capable to reduce the incidence of acute graft rejection in adult and pediatric liver transplantation ( Ltx ) . However , data on long-term results using basiliximab in children post-Ltx are still pending . Therefore , the objective of our study was to report on the long-term results of basiliximab induction therapy in pediatric liver transplant recipients . A total of 54 children received two single doses of basiliximab in addition to cyclosporine and prednisolone following Ltx . We analyzed the incidence of acute and chronic graft rejection that of post-transplant lymphoproliferative disease ( PTLD ) , and patient and graft survival . The follow-up was 22 - 46 months . The historical control group ( 
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AUTHORS ' CONCLUSIONS Because of the low quality of the evidence , the effects of T-cell antibody induction remain uncertain .
T-cell specific antibody induction seems to reduce diabetes mellitus and may reduce cytomegalovirus infection when compared with corticosteroid induction .
No other clear benefits or harms were associated with the use of T-cell specific antibody induction compared with corticosteroid induction .