Open AccessLong‐term efficacy and safety of mycophenolate mofetil in liver transplant recipients with calcineurin inhibitor‐induced renal dysfunction
Author(s) -
Koch Robert O.,
Graziadei Ivo W.,
Schulz Frank,
Nachbaur Karin,
Königsrainer Alfred,
Margreiter Raimund,
Vogel Wolfgang
Publication year - 2004
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/j.1432-2277.2004.tb00481.x
Subject(s) - medicine , calcineurin , immunosuppression , tacrolimus , urology , nephrotoxicity , concomitant , creatinine , renal function , mycophenolate , adverse effect , nephropathy , liver transplantation , gastroenterology , transplantation , chronic allograft nephropathy , kidney transplantation , kidney , endocrinology , diabetes mellitus
Long‐term survival after orthotopic liver transplantation (OLT) is mainly influenced by adverse events caused by immunosuppression. Several studies have shown the efficacy of mycophenolate mofetil (MMF) in improving calcineurin inhibitor (CI)‐induced nephrotoxicity with concomitant reduction or withdrawal of CI. In this prospective study we assessed the long‐term effect and safety of MMF. Thirty‐two OLT recipients with significant renal impairment due to either cyclosporine A ( n =25) or tacrolimus ( n =7) were enrolled in this study. CIs were reduced stepwise by at least 70%. Mean serum creatinine had decreased from 2.63±0.39 to 1.74±0.34 mg/dl after 1 month, and this improvement was maintained within a follow‐up period of 4.8±0.6 (range 3.1–6.0) years, without major immunological or nonimmunological side effects. Of all participants, 88% showed a significant reduction, and 41% even a normalization, in their serum creatinine level. In addition, MMF conversion, within 6 months of OLT, appears to be crucial in order to improve or even normalize renal function. This study demonstrates the long‐term efficacy and safety of MMF in OLT recipients with CI‐induced nephropathy.