PTH-134 Reduced calcineurin inhibitor exposure early after liver transplantation protects against renal dysfunction independently of the use of basiliximab induction therapy

Autor: L. De Luca, S. Onali, D. Patch J O’Beirne, A. Mansell, Douglas Thorburn, P. Manousou, Massimo Pinzani, Emmanuel Tsochatzis, S. Aspite
Rok vydání: 2015
Předmět:
Zdroj: Gut. 64:A467.2-A467
ISSN: 1468-3288
0017-5749
Popis: Introduction Basiliximab use with delayed entry of Tacrolimus (TAC) as renal sparing agent may help reduce renal impairment in liver transplant (LT) recipients. We aimed to evaluate factors affecting renal dysfunction and the effect of basiliximab post-LT. Method All consecutive LT patients (1/2006–1/2014) with a follow up >3months and eGFR 2 at day 1 post-LT were analysed for factors known to affect renal dysfunction: biochemical/clinical data, donor age, cold/warm ischemia time, mean trough TAC levels up to days 7, 15, 30 post-LT, basiliximab use, initial/maintenance immunosuppression, acute cellular rejection (ACR), diabetes mellitus (DM) pre and post-LT, systemic hypertension, days on filtration post-LT. Renal impairment was defined as mild: eGFR 60–89 and moderate/severe: eGFR Results 126 patients given basiliximab were compared with 189 consecutive patients with eGFR 5 ng/ml vs 41%(38/92) with TAC Logistic regression analysis showed that factors associated with moderate-severe renal impairment (eGFR 50years (p 5 ng/ml at week 1 post-LT(p = 0.003, OR=0.4, 95% CI=0.3–0.7) and mean CNI levels >7 ng/ml up to 15 days post-LT(p = 0.019 OR=0.85, 95% CI=0.75–0.97). The same factors were associated with mild renal impairment (eGFR 7 ng/ml at days 15 post-LT (p = 0.003 OR=1,9 95% CI=1.2–2.9) and use of steroids >3months post-LT(p = 0.006, OR=0.7, 95% CI=0.5–0.9). Conclusion Basiliximab use allows reduced TAC trough levels with less episodes of ACR compared with the control group. However, TAC trough levels Disclosure of interest None Declared.
Databáze: OpenAIRE
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