Zusammenfassung
The benefits of calcineurin inhibitor (CNI)-sparing regimens on renal function following liver transplantation (LT) have been demonstrated in clinical studies. This observational study assessed the real-life effects of mycophenolate mofetil (MMF) introduction in LT patients. Four hundred and ninety-seven patients in whom MMF was introduced according to local standards or clinical considerations ...
Zusammenfassung
The benefits of calcineurin inhibitor (CNI)-sparing regimens on renal function following liver transplantation (LT) have been demonstrated in clinical studies. This observational study assessed the real-life effects of mycophenolate mofetil (MMF) introduction in LT patients. Four hundred and ninety-seven patients in whom MMF was introduced according to local standards or clinical considerations were entered. Patients were grouped by time between transplantation and start of MMF (start of study): Group A (n=263): 6d; Group B (n=64): >6d to 1month; Group C (n=74): >1month to 1yr; and Group D (n=96): >1yr. CNI sparing occurred in all groups, particularly in Groups C and D. Mean MMF doses at 12months were 1202.7, 1363.5, 1504.7, and 1578.1mg/d, respectively, in Groups A-D. At introduction of MMF, median glomerular filtration rate was 73.3, 81.7, 62.7, and 53.7mL/min/1.73m2 in Groups A-D. At 12months, this decreased to 66mL/min/1.73m2 in Groups A and B, remained stable in Group C, and increased in Group D (64.8mL/min/1.73m2). Serious adverse drug reactions were lowest in Group D. In conclusion, MMF with a subsequent decrease in CNI was well tolerated and improved renal function even years after transplantation. A more forceful MMF dosing strategy with greater CNI sparing may further improve renal function.
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