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

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...

Authors: Hüsing, Anna Katharina Elisabeth Pia
Schmidt, Martina
Beckebaum, Susanne
Cicinnati, Vito R.
Koch, Raphael
Thölking, Gerold Bernhard
Stella, Jaqueline
Heinzow, Hauke S.
Schmidt, Hartmut
Kabar, Iyad
Division/Institute:FB 05: Medizinische Fakultät
Document types:Article
Media types:Text
Publication date:2015
Date of publication on miami:11.01.2016
Modification date:27.01.2020
Edition statement:[Electronic ed.]
Source:Annals of Transplantation 20 (2015), 707-713
Subjects:Calcineurin; Immunosuppression; Liver Transplantation; renal insufficiency; TOR Serine-Threonine Kinases
DDC Subject:610: Medizin und Gesundheit
License:CC BY-NC-ND 4.0
Language:English
Notes:Finanziert durch den Open-Access-Publikationsfonds 2015/2016 der Westfälischen Wilhelms-Universität Münster (WWU Münster).
Format:PDF document
ISSN:2329-0358
URN:urn:nbn:de:hbz:6-17229622530
Permalink:http://nbn-resolving.de/urn:nbn:de:hbz:6-17229622530
Other Identifiers:DOI: 10.12659/AOT.895320
Digital documents:895320.pdf

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