TY - JOUR
T1 - Two yr mycophenolate mofetil plus low-dose calcineurin inhibitor for renal dysfunction after liver transplant
AU - Biselli, Maurizio
AU - Vitale, Giovanni
AU - Gramenzi, Annagiulia
AU - Riili, Anna
AU - Berardi, Sonia
AU - Cammà, Carlo
AU - Scuteri, Alessandra
AU - Morelli, Maria Cristina
AU - Grazi, Gian Luca
AU - Pinna, Antonio Daniele
AU - Andreone, Pietro
AU - Bernardi, Mauro
PY - 2009
Y1 - 2009
N2 - We assessed the efficacy and outcome of low through level of calcineurin inhibitors (CNI) and introducing mycophenolate mofetil (MMF) in liver transplant (LT) patients with CNI-related renal dysfunction. Thirty LT patients were converted to combined therapy and compared with 30 patients used as a contemporary control group receiving CNI only. The two groups were matched for sex, age, months after LT, immunosuppressive treatment, creatinine level, presence of diabetes and calculated glomerular filtration rate (GFR) via Cockroft-Gault method. After two years, in the MMF serum creatinine decreased from 1.65 mg/dL (range 1.33-3.5) to 1.4 mg/dL (range 0.9-4.7) (p = 0.002) and GFR increased from 51 mL/min (range 18.9-72.2) to 57.6 mL/min (range 16-92.2) (p <0.001), whereas the controls not showed any improvement. The logistic regression models employing improvement of creatinine and GFR of at least 10% with respect to baseline as dependent variables showed the use of MMF (p = 0.004 and p = 0.019, respectively) as the only statistically significant parameter. Multiple linear regression analysis identified only MMF as independent predictor of Δcreatinine and ΔGFR (p = 0.002 and p <0.001, respectively). No rejection episode was observed (three in controls). This study demonstrates the medium-term efficacy and safety of MMF plus low dose CNI in reducing nephrotoxicity in LT recipients.
AB - We assessed the efficacy and outcome of low through level of calcineurin inhibitors (CNI) and introducing mycophenolate mofetil (MMF) in liver transplant (LT) patients with CNI-related renal dysfunction. Thirty LT patients were converted to combined therapy and compared with 30 patients used as a contemporary control group receiving CNI only. The two groups were matched for sex, age, months after LT, immunosuppressive treatment, creatinine level, presence of diabetes and calculated glomerular filtration rate (GFR) via Cockroft-Gault method. After two years, in the MMF serum creatinine decreased from 1.65 mg/dL (range 1.33-3.5) to 1.4 mg/dL (range 0.9-4.7) (p = 0.002) and GFR increased from 51 mL/min (range 18.9-72.2) to 57.6 mL/min (range 16-92.2) (p <0.001), whereas the controls not showed any improvement. The logistic regression models employing improvement of creatinine and GFR of at least 10% with respect to baseline as dependent variables showed the use of MMF (p = 0.004 and p = 0.019, respectively) as the only statistically significant parameter. Multiple linear regression analysis identified only MMF as independent predictor of Δcreatinine and ΔGFR (p = 0.002 and p <0.001, respectively). No rejection episode was observed (three in controls). This study demonstrates the medium-term efficacy and safety of MMF plus low dose CNI in reducing nephrotoxicity in LT recipients.
KW - Calcineurin inhibitors
KW - Immunosuppression
KW - Liver transplantation
KW - Mycophenolate mofetil
KW - Renal dysfunction
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U2 - 10.1111/j.1399-0012.2009.00965.x
DO - 10.1111/j.1399-0012.2009.00965.x
M3 - Article
C2 - 19210525
AN - SCOPUS:64349085834
VL - 23
SP - 191
EP - 198
JO - Clinical Transplantation
JF - Clinical Transplantation
SN - 0902-0063
IS - 2
ER -