Two yr mycophenolate mofetil plus low-dose calcineurin inhibitor for renal dysfunction after liver transplant

Maurizio Biselli, Giovanni Vitale, Annagiulia Gramenzi, Anna Riili, Sonia Berardi, Carlo Cammà, Alessandra Scuteri, Maria Cristina Morelli, Gian Luca Grazi, Antonio Daniele Pinna, Pietro Andreone, Mauro Bernardi

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)191-198
Number of pages8
JournalClinical Transplantation
Volume23
Issue number2
DOIs
Publication statusPublished - 2009

Keywords

  • Calcineurin inhibitors
  • Immunosuppression
  • Liver transplantation
  • Mycophenolate mofetil
  • Renal dysfunction

ASJC Scopus subject areas

  • Transplantation

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  • Cite this

    Biselli, M., Vitale, G., Gramenzi, A., Riili, A., Berardi, S., Cammà, C., Scuteri, A., Morelli, M. C., Grazi, G. L., Pinna, A. D., Andreone, P., & Bernardi, M. (2009). Two yr mycophenolate mofetil plus low-dose calcineurin inhibitor for renal dysfunction after liver transplant. Clinical Transplantation, 23(2), 191-198. https://doi.org/10.1111/j.1399-0012.2009.00965.x