Efficacy and safety of a reduced calcineurin inhibitor dose combined with mycophenolate mofetil in liver transplant patients with chronic renal dysfunction
| Autor: | Qifa Ye, Lvnan Yan, Zhanyu Yang, Zhiren Fu, Weitao Que, Pusen Wang, Hao Li, Zhijun Zhu, Guihua Chen, Lin Zhong, Kefeng Dou, Shi-Chun Lu, Zhihai Peng |
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| Rok vydání: | 2017 |
| Předmět: |
safety
medicine.medical_specialty medicine.medical_treatment efficacy Population Renal function 030230 surgery Liver transplantation Organ transplantation Nephrotoxicity 03 medical and health sciences 0302 clinical medicine Internal medicine medicine education education.field_of_study liver transplantation business.industry mycophenolate mofetil calcineurin inhibitors Surgery Calcineurin Transplantation Regimen Oncology 030211 gastroenterology & hepatology Clinical Research Paper business |
| Zdroj: | Oncotarget |
| ISSN: | 1949-2553 |
| DOI: | 10.18632/oncotarget.15490 |
| Popis: | // Pusen Wang 1,* , Weitao Que 1,* , Hao Li 1,* , Lvnan Yan 2 , Zhiren Fu 3 , Qifa Ye 4 , Guihua Chen 5 , Kefeng Dou 6 , Shichun Lu 7 , Zhanyu Yang 8 , Zhijun Zhu 9 , Zhihai Peng 1 and Lin Zhong 1 1 Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China 2 Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China 3 Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University, Shanghai, China 4 Engineering and Technology Research Center for Transplantation Medicine of the National Ministry of Health, The Third Xiangya Hospital, Central South University, Changsha, China 5 Department of Liver Transplantation, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China 6 Department of Hepatobiliary Surgery, Xijing Hospital, The Fourth Military Medical University, Xian, China 7 Department of Liver Transplantation, Beijing Youan Hospital, Capital Medical University, Beijing, China 8 Department of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China 9 Department of Transplantation, Tianjin First Central Hospital, Tianjin Medical University, Tianjin, China * These authors have contributed equally to this work Correspondence to: Lin Zhong, email: // Zhihai Peng, email: // Keywords : calcineurin inhibitors, mycophenolate mofetil, liver transplantation, efficacy, safety Received : December 28, 2016 Accepted : February 08, 2017 Published : February 18, 2017 Abstract Calcineurin inhibitors (CNIs) are frequently given at a reduced dose in combination with mycophenolate mofetil (MMF) to avoid nephrotoxicity, but the optimal reduction in CNI dose has not been established. In this prospective, open-label, multicenter study, liver transplant recipients with chronic renal dysfunction who were administered a CNI-based immunosuppressive regimen were included in the intent-to-treat (ITT) population. The primary endpoint was declination in renal function, which was defined as a ≥ 20% decrease in the glomerular filtration rate during the year following regimen adjustment. In the ITT population, renal function declined after regimen adjustment in three patients (7%) in the MMF plus 50% CNI reduction group. Additionally, three of 40 patients (7.5%) in the MMF plus 75% CNI reduction group experienced at least one clinically suspected or biopsy-proven acute rejection. There were no differences between the two groups. The corrected mean improvement in creatinine clearance at week 52 was 6.551 mL/min in the MMF plus 50% CNI reduction group and 6.442 mL/min in the MMF plus at least 75% CNI reduction group. Thus, a regimen of MMF combined with a 50% or at least 70% reduction in CNI dose could improve renal function and was both tolerable and safe. |
| Databáze: | OpenAIRE |
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