Aguiar, DiegoMartinez-Urbistondo, DiegoBaroja-Mazo, Albertode la Mata, ManuelRodriguez-Peralvarez, ManuelRubin, AngelPuchades, LorenaSerrano, TrinidadMontero, JessicaCuadrado, AntonioCasafont, FernandoSalcedo, MagdalenaRincon, DiegoPons, Jose AHerrero, Jose I2023-01-252023-01-252016-12-30Aguiar 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;22:265-275http://hdl.handle.net/10668/11153BACKGROUND 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.enAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Drug-Related Side Effects and Adverse ReactionsLiver TransplantationTransplantation toleranceAge FactorsCardiovascular DiseasesCross-Sectional StudiesCyclosporineFemaleHumansImmunosuppressive AgentsLiver DiseasesLiver TransplantationMaleMiddle AgedRisk FactorsTacrolimusTransplant Recipientsresearch article28461684open accessCiclosporinaEnfermedades cardiovascularesEstudios transversalesHepatopatiasInmunosupresoresReceptores de trasplantesTrasplante de higado10.12659/aot.9025232329-0358PMC6248177https://europepmc.org/articles/pmc6248177?pdf=renderhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248177/pdf