RT Journal Article
T1 Real-World Multicenter Experience of Immunosuppression Minimization Among 661 Liver Transplant Recipients.
A1 Aguiar, Diego
A1 Martinez-Urbistondo, Diego
A1 Baroja-Mazo, Alberto
A1 de la Mata, Manuel
A1 Rodriguez-Peralvarez, Manuel
A1 Rubin, Angel
A1 Puchades, Lorena
A1 Serrano, Trinidad
A1 Montero, Jessica
A1 Cuadrado, Antonio
A1 Casafont, Fernando
A1 Salcedo, Magdalena
A1 Rincon, Diego
A1 Pons, Jose A
A1 Herrero, Jose I
K1 Drug-Related Side Effects and Adverse Reactions
K1 Liver Transplantation
K1 Transplantation tolerance
AB 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 AND 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.
PB International Scientific Information
YR 2016
FD 2016-12-30
LK http://hdl.handle.net/10668/11153
UL http://hdl.handle.net/10668/11153
LA en
NO Aguiar D, Martínez-Urbistondo D, Baroja-Mazo A, de la Mata M, Rodríguez-Perálvarez M, Rubín A, et al. Real-World Multicenter Experience of Immunosuppression Minimization Among 661 Liver Transplant Recipients. Ann Transplant. 2017 May 2;22:265-275
DS RISalud
RD Apr 11, 2025