Evidence map›Paper›PMID 36340316›Full record

ReviewJournal of clinical and experimental hepatology

Immunosuppressive Drugs in Liver Transplant: An Insight.

Charles Panackel, Joe F Mathew, Mohamed Fawas N, Mathew Jacob

Abstract readReview
In one paragraph

Review in Journal of clinical and experimental hepatology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Tensor-based integration of time-series measurements reveals relationships between underlying disease, early injury, and T cell polarization in liver transplantation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026
    Article
  4. Article
  5. Article
  6. Induction of Clinical Operational Tolerance Through Immunosuppression Minimization: Less Is More?Liver international : official journal of the International Association for the Study of the Liver · 2026
    Review
  7. Article
  8. Inhibition of LDHA promotes GSDME-dependent pyroptosis by activating RIG-I-like receptor signaling.Apoptosis : an international journal on programmed cell death · 2026
    Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Review
  14. Polysaccharides derived from alkali-extracted vinegar-bakedJournal of traditional and complementary medicine · 2025
    Article
  15. Article
  16. Review
  17. Review
  18. Cytopenias in Autoimmune Liver Diseases-A Review.Journal of clinical medicine · 2025
    Review
  19. Side Effects of Immunosuppressant Drugs After Liver Transplant.Pharmaceuticals (Basel, Switzerland) · 2025
    Review
  20. Update on the Complications and Management of Liver Cirrhosis.Medical sciences (Basel, Switzerland) · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Charles PanackelAster Integrated Liver Care, Aster Medcity, Kochi, Kerala, 682027, India.
Joe F MathewAster Integrated Liver Care, Aster Medcity, Kochi, Kerala, 682027, India.
Mohamed Fawas NAster Integrated Liver Care, Aster Medcity, Kochi, Kerala, 682027, India.
Mathew JacobAster Integrated Liver Care, Aster Medcity, Kochi, Kerala, 682027, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Liver transplantation (LT) is the standard of care for end-stage liver failure and hepatocellular carcinoma. Over the years, immunosuppression regimens have improved, resulting in enhanced graft and patient survival. At present, the side effects of immunosuppressive agents are a significant threat to post-LT quality of life and long-term outcome. The role of personalized immunosuppression is to reach a delicate balance between optimal immunosuppression and minimal side effects. Today, immunosuppression in LT is more of an art than a science. There are no validated markers for overimmunosuppression and underimmunosuppression, only a few drugs have therapeutic drug monitoring and immunosuppression regimens vary from center to center. The immunosuppressive agents are broadly classified into biological agents and pharmacological agents. Most regimens use multiple agents with different modes of action to reduce the dosage and minimize the toxicities. The calcineurin inhibitor (CNI)-related toxicities are reduced by antibody induction or using mTOR inhibitor/antimetabolites as CNI sparing or CNI minimization strategies. Post-liver transplant immunosuppression has an intensive phase in the first three months when alloreactivity is high, followed by a maintenance phase when immunosuppression minimization protocols are implemented. Over time some patients achieve "tolerance," defined as the successful stopping of immunosuppression with good graft function and no indication of rejection. Cell-based therapy using immune cells with tolerogenic potential is the future and may permit complete withdrawal of immunosuppressive agents.

Indexed as

AMR, Antibody-mediated rejectionantimetabolitesAPCs, Antigen-presenting cellsATG, Anti-thymocyte globulinbasiliximabcalcineurin inhibitorsCNI, Calcineurin inhibitorsCsA, Cyclosporine AcyclosporineeverolimusEVR, EverolimusIL-2R, Interleukin 2 Receptorimmunosuppressionliver transplantationLT, Liver transplantationMMF, Mycophenolate mofetilMPA, Mycophenolic acidmTORi, mammalian targets of rapamycin inhibitormycophenolate mofetilSRL, SirolimustacrolimusTAC, TacrolimusTCMR, T-cell-mediated rejection

Identifiers

PMID36340316
PMCPMC9630030

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.