TY  - JOUR
AB  - 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.
AU  - Hüsing, Anna Katharina Elisabeth Pia
AU  - Schmidt, Martina
AU  - Beckebaum, Susanne
AU  - Cicinnati, Vito R.
AU  - Koch, Raphael
AU  - Thölking, Gerold Bernhard
AU  - Stella, Jaqueline
AU  - Heinzow, Hauke
AU  - Schmidt, Hartmut
AU  - Kabar, Iyad
DA  - 2015-11-26
DO  - 10.12659/AOT.895320
KW  - Calcineurin
KW  - Immunosuppression
KW  - Liver Transplantation
KW  - renal insufficiency
KW  - TOR Serine-Threonine Kinases
LA  - eng
N1  - Annals of Transplantation 20 (2015), 707-713
N1  - Finanziert durch den Open-Access-Publikationsfonds 2015/2016 der Westfälischen Wilhelms-Universität Münster (WWU Münster).
PY  - 2015-11-26
SN  - 2329-0358
TI  - Long-Term Renal Function in Liver Transplant Recipients After Conversion From Calcineurin Inhibitors to mTOR Inhibitors
UR  - https://nbn-resolving.org/urn:nbn:de:hbz:6-17229622530
Y2  - 2024-11-14T06:47:20
ER  -