Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

26 November 2015 : Original article  

Long-Term Renal Function in Liver Transplant Recipients After Conversion From Calcineurin Inhibitors to mTOR Inhibitors

Anna HüsingABDE, Martina SchmidtBDE, Susanne BeckebaumADE, Vito R. CicinnatiADE, Raphael KochCD, Gerold ThölkingABE, Jaqueline StellaBEF, Hauke HeinzowADE, Hartmut H. SchmidtADE, Iyad KabarABDEFG

DOI: 10.12659/AOT.895320

Ann Transplant 2015; 20:707-713

Abstract

BACKGROUND: Renal dysfunction often occurs in liver transplant (LT) recipients receiving calcineurin inhibitor (CNI)-based immunosuppressive regimens, increasing morbidity and mortality rates. Replacement of CNIs by mTOR inhibitor-based immunosuppressive protocols may prevent renal impairment in LT recipients.

MATERIAL AND METHODS: Outcomes in patients who underwent LT between 1996 and 2010 at our center and who were switched from CNI-based to mTOR inhibitor-based immunosuppression were retrospectively analyzed. Renal course, hyperlipidemia, and graft rejection were assessed in patients maintained on this CNI-free regimen for at least 24 months.

RESULTS: Of the 85 patients switched from CNI-based to mTOR inhibitor-based, CNI-free immunosuppression, 78 met the inclusion criteria. Within the first 6 weeks after switching, the covariable adjusted estimated glomerular filtration rate (eGFR) increased 5.6 mL/min [95% confidence interval 2.6–8.7 mL/min, p<0.001], but there were no further statistically noticeable changes in eGFR. Concentrations of cholesterol and triglycerides increased statistically, noticeable within the first 12 months after drug conversion. Histologically proven graft rejection was observed in 4 patients (5.1%) after conversion.

CONCLUSIONS: Conversion from CNI-based to CNI-free, mTOR inhibitor-based immunosuppression after LT is safe and can result in significant renal recovery. CNI-free, mTOR inhibitor-based immunosuppression is a potential option for patients with contraindications for CNIs and for LT recipients with rapid reduction in kidney function due to CNIs.

Keywords: Immunosuppression, Liver Transplantation, renal insufficiency, TOR Serine-Threonine Kinases

Add Comment 0 Comments

In Press

Original article  

Impact of Preoperative Treatment on Donor Hepatic Steatosis in Living Donor Liver Transplantation

Ann Transplant In Press; DOI: 10.12659/AOT.947772  

Original article  

Effects of Donor-Recipient Race Matching on Kidney Transplant Survival

Ann Transplant In Press; DOI: 10.12659/AOT.947720  

Most Viewed Current Articles

03 Jan 2023 : Original article   6,996

Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and...

DOI :10.12659/AOT.938467

Ann Transplant 2023; 28:e938467

15 Aug 2023 : Review article   6,986

Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ Transplantation

DOI :10.12659/AOT.939750

Ann Transplant 2023; 28:e939750

16 May 2023 : Original article   6,742

Breaking Antimicrobial Resistance: High-Dose Amoxicillin with Clavulanic Acid for Urinary Tract Infections ...

DOI :10.12659/AOT.939258

Ann Transplant 2023; 28:e939258

28 May 2024 : Original article   6,162

Effect of Dexmedetomidine Combined with Remifentanil on Emergence Agitation During Awakening from Sevoflura...

DOI :10.12659/AOT.943281

Ann Transplant 2024; 29:e943281

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358