ArticleDigestive diseases and sciences2011
Sustained renal response to mycophenolate mofetil and CNI taper promotes survival in liver transplant patients with CNI-related renal dysfunction.
Article in Digestive diseases and sciences, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 18 citations in OpenAlex.
- Influence of immunosuppressive drugs on natural killer cells in therapeutic drug exposure in liver transplantation.Hepatobiliary surgery and nutrition · 2023Article
- Current aspects of renal dysfunction after liver transplantation.World journal of hepatology · 2022Review
- Key role of renal biopsy in management of progressive chronic kidney disease in liver graft recipients.Journal of nephrology · 2019Article
- Protecting the Kidney in Liver Transplant Recipients: Practice-Based Recommendations From the American Society of Transplantation Liver and Intestine Community of Practice.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2016Review
- Evolving concepts in the selection of immunosuppression regimen for liver transplant recipients.Hepatic medicine : evidence and research · 2011Review
- Conversion to combined mycophenolate mofetil and low-dose calcineurin inhibitor therapy for renal dysfunction in liver transplant patients: never too late?Digestive diseases and sciences · 2011Article
- Long-term Management of the Adult Liver Transplantation Recipients.Journal of clinical and experimental hepatologyReview
- The Renal Histological Correlates of Refractory Renal Dysfunction After Liver Transplantation.Journal of clinical and experimental hepatologyArticle
- Long Term Complications of Immunosuppression Post Liver Transplant.Journal of clinical and experimental hepatologyArticle
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimThe aim of this trial was to evaluate the impact of conversion from a calcineurin-inhibitor (CNI)-based immunosuppressive regimen to mycophenolate mofetil (MMF) and reduced-dose CNI on long-term renal function and survival in a series of 63 liver transplant patients with CNI-induced renal dysfunction.
methodsCNI dosage was significantly tapered after introduction of 2,000 mg MMF per day. Renal function was assessed by determination of serum creatinine levels and calculated creatinine clearance (CCl). The impact of relevant clinical parameters on renal function and survival post-conversion was analyzed by univariate and multivariate analysis.
resultsAt 60 months post-conversion, mean creatinine level had significantly declined from 197.2±58.3 μmol/l at baseline to 160.0±76.5 μmol/l, and mean CCl has significantly increased from 38.4±13.4 ml/min at baseline to 47.9±21.1 ml/min (p<0.001), respectively. Forty-six patients (73.1%) demonstrated sustained renal response to modified immunosuppression. Full-dose MMF medication (p=0.006) and the early conversion (p=0.02) were identified as independent predictors of persistent renal function improvement. Sustained renal response to MMF plus reduced-dose CNI was identified as the most relevant independent promoter of long-term survival (hazard ratio 6.9). Five-year survival rate post-conversion was 93.9% in renal responders and 64.3% in renal non-responders (log rank<0.001).
conclusionsSustained renal response to MMF and CNI dose reduction promotes long-term survival in liver transplant patients with CNI-induced renal dysfunction.
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