Combination of everolimus and low-dose tacrolimus controls histological liver allograft injury as sufficiently as high-dose tacrolimus

Autor: Emily A. Bosselmann, Fabian Dranicki, Alejandro Campos-Murguia, Björn Hartleben, Heiner Wedemeyer, Elmar Jaeckel, Richard Taubert
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Frontiers in Transplantation, Vol 2 (2023)
Druh dokumentu: article
ISSN: 2813-2440
DOI: 10.3389/frtra.2023.1168163
Popis: IntroductionThe combination of everolimus (EVR) and low-dose tacrolimus (lowTAC) prevents T cell-mediated rejection of liver grafts as sufficiently as high-dose tacrolimus (highTAC) and mycophenolate, but is associated with a preserved kidney function within the first years after orthotopic liver transplantation (OLT). However, none of the available studies assessed the histological pattern of graft injury or fibrosis in surveillance biopsies (svLbx).MethodsAll svLbx taken under at least one month of stable immunosuppression with either EVR (aim 3-8 ng/ml) combined with lowTAC (aim 3-5 ng/ml) or highTAC (aim 5-8 ng/ml) combined with mycophenolate (500-1500 mg/day) within the first three to four years after OLT at our center were included. Patients who were switched to EVR because of insufficient control of alloreactivity were excluded.ResultsReasons for switches to EVR were mainly malignancies before or after OLT, or chronic kidney injury. We were able to include 20 svLbx with EVR/lowTAC and 49 with highTAC/mycophenolate. Both groups had similar liver enzymes and similar kidney function. The EVR/lowTAC group exhibited lower TAC trough levels at svLbx (4.4 vs. 6.6 ng/ml; p
Databáze: Directory of Open Access Journals