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Real-World Multicenter Experience of Immunosuppression Minimization Among 661 Liver Transplant Recipients

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Aguiar, D
  • Martinez-Urbistondo, D
  • Baroja-Mazo, A
  • de la Mata, M
  • Rodriguez-Peralvarez, M
  • Serrano, T
  • Montero, J
  • Cuadrado, A
  • Casafont, F
  • Salcedo, M
  • Rincon, D
  • Pons, JA
  • Herrero, JI

Grupos

Abstract

Background: Long-term morbidity and mortality in liver transplant recipients is frequently secondary to immunosuppression toxicity. However, data are scarce regarding immunosuppression minimization in clinical practice. Material/Methods: In this cross-sectional, multicenter study, we reviewed the indications of immunosuppression minimization (defined as tacrolimus levels below 5 ng/mL or cyclosporine levels below 50 ng/mL) among 661 liver transplant recipients, as well as associated factors and the effect on renal function. Results: Fifty-three percent of the patients received minimized immunosuppression. The median time from transplantation to minimization was 32 months. The most frequent indications were renal insufficiency (49%), cardiovascular risk (19%), de novo malignancy (8%), and cardiovascular disease (7%). The factors associated with minimization were older age at transplantation, longer post-transplant follow-up, pre-transplant diabetes mellitus and renal dysfunction, and the hospital where the patients were being followed. The patients who were minimized because of renal insufficiency had a significant improvement in renal function (decrease of the median serum creatinine level, from 1.50 to 1.34 mg/dL; P=0.004). Renal function significantly improved in patients minimized for other indications, too. In the long term, glomerular filtration rate significantly decreased in non-minimized patients and remained stable in minimized patients. Conclusions: Immunosuppression minimization is frequently undertaken in long-term liver transplant recipients, mainly for renal insufficiency. Substantial variability exists regarding the use of IS minimization among centers.

Datos de la publicación

ISSN/ISSNe:
1425-9524, 2329-0358

Annals of Transplantation  INT SCIENTIFIC INFORMATION, INC

Tipo:
Article
Páginas:
265-275
PubMed:
28461684
Factor de Impacto:
0,456 SCImago ℠
Cuartil:
Q3 SCImago ℠

Citas Recibidas en Web of Science: 9

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Keywords

  • Drug-Related Side Effects and Adverse Reactions; Liver Transplantation; Transplantation Tolerance

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