Premium
Treatment of renal dysfunction after orthotopic liver transplantation: Options and outcomes
Author(s) -
Gonwa Thomas A.
Publication year - 2003
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.500090722
Subject(s) - medicine , calcineurin , nephrotoxicity , tacrolimus , liver transplantation , azathioprine , transplantation , urology , renal function , creatinine , gastroenterology , surgery , kidney , disease
Abstract Chronic nephrotoxicity is one of the most serious side‐effects of calcineurin inhibitor treatment and a factor in mortality and morbidity after liver transplantation. In our transplant centre, among patients who underwent a liver transplantation between January 1989 and December 2000, 14 liver graft recipients (6.86%) developed de novo severe renal dysfunction as defined by a serum creatinine concentration above 200 micromol/L. Renal biopsy was performed in nine cases and evidenced histological lesions compatible with chronic nephrotoxicity related to calcineurin inhibitor treatment. For nine patients, we report the results of a prospective non‐randomized study consisting of cyclosporine or tacrolimus withdrawal associated with administration of mycophenolate mofetil or azathioprine. Despite this therapeutic modification, we did not observe a significant renal function improvement but on the other hand, there was no graft rejection. (Clin Transplant 2002;16:368‐373.)