Use of mycophenolate mofetil as rescue therapy after pediatric liver transplantation
| Autor: | C. Chardot, Etienne Sokal, J.E. Nicoluzzi, Raymond Reding, Jean-Bernard Otte, Jan Lerut, M. Janssen |
|---|---|
| Přispěvatelé: | Physical Chemistry |
| Jazyk: | angličtina |
| Rok vydání: | 2001 |
| Předmět: |
Graft Rejection
Male Herpesvirus 4 Human medicine.medical_specialty medicine.medical_treatment Liver transplantation Gastroenterology Mycophenolic acid Internal medicine Humans Medicine Child Salvage Therapy Hepatitis Transplantation Chemotherapy medicine.diagnostic_test business.industry Immunosuppression Mycophenolic Acid medicine.disease Burkitt Lymphoma Lymphoproliferative Disorders Tacrolimus Liver Transplantation Surgery Child Preschool Cytomegalovirus Infections Female business Liver function tests medicine.drug |
| Zdroj: | Chardot, C, Nicoluzzi, J E, Janssen, M H M, Sokal, E, Lerut, J, Otte, J B & Reding, R 2001, ' Use of mycophenolate mofetil as rescue therapy after pediatric liver transplantation ', Transplantation, vol. 71, no. 2, pp. 224-9 . https://doi.org/10.1097/00007890-200101270-00009 Scopus-Elsevier Transplantation, 71(2), 224-9. Lippincott Williams and Wilkins |
| ISSN: | 0041-1337 |
| DOI: | 10.1097/00007890-200101270-00009 |
| Popis: | BACKGROUND: Mycophenolate mofetil (MMF) has been increasingly used after liver transplantation (LT) in adults. We report our preliminary experience with MMF as rescue therapy after pediatric LT. METHODS: A total of 19 children received MMF for 21 indications. Median age at LT was 30 months (range 7-149). The median initial oral dose of MMF was 23 mg/kg/day (range 12-43) orally. Median follow-up after initiation of MMF therapy was 642 days (range 229-1606). RESULTS: 1) Efficacy: MMF was indicated for rejection or insufficient immunosuppression in 16 cases, with normalization of both liver function tests and liver histology in 10 (62%). MMF was successfully used in one patient with post-LT immmune hepatitis and one patient with corticodependence. In three patients with renal function impairment, MMF allowed reduction of cyclosporine A or tacrolimus blood levels, without subsequent rejection. 2) Tolerance: Six patients (32%) experienced eight side effects, mainly gastrointestinal and hematological, which resolved after cessation of MMF in five cases and dose reduction in three. One case of posttransplant lymphoproliferative disease (PTLD) occurred under MMF therapy (5.2%). Four patients had EBV primary infection, while under MMF therapy, without subsequent PTLD. Three patients had CMV primary infection, and five CMV reactivation, under MMF therapy. Seven remained asymptomatic, and one presented with CMV enteritis. CONCLUSIONS: These preliminary results suggest that MMF is an effective and safe immunosuppressant in pediatric LT recipients. Its use is hampered by frequent gastrointestinal and hematological side-effects. MMF does not seem to increase the risk of PTLD nor CMV disease. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|