Efficacy and Safety of Mycophenolate Mofetil as Part of Induction Therapy in Liver Transplantation

• Published in: Transplantation proceedings Vol. 37; no. 9; pp. 3926 - 3929
• Main Authors: Pareja-Ciuró, F., Dı́ez-Canedo, J. Serrano, Gómez-Bravo, M.A., Garcı́a-Gonzalez, I., Tamayo-López, M.J., Sousa-Martı́n, J.M., Pascasio-Acevedo, J.M., Porras-Lopez, M.F., Gavilán-Carrasco, F., Bernardos-Rodrı́guez, A.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01-11-2005; Elsevier Science
• Subjects: Adult; Aged; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Biological and medical sciences; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Immunosuppression - methods; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Liver Diseases - classification; Liver Diseases - surgery; Liver Transplantation - immunology; Medical sciences; Middle Aged; Mycophenolic Acid - adverse effects; Mycophenolic Acid - analogs & derivatives; Mycophenolic Acid - therapeutic use; Pharmacology. Drug treatments; Retrospective Studies; Safety; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Analysis; Time Factors; Tissue, organ and graft immunology; Mofetil; Mycophenolic acid; Digestive system; Toxicity; Liver; Transplantation; Homotransplantation; Induction treatment; Immunomodulator; Medicine; Antibiotic; Chemotherapy; Efficiency; Surgery; Antiviral; Complication; Graft; Immunosuppressive agent; Mycophenolate mofetil; Safety
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2005.10.058

To report our experience with mycophenolate mofetil (MMF) for induction and maintenance therapy to prevent acute liver transplant rejection.
A retrospective analysis of 66 elective, noncombined liver transplant patients treated beginning de novo MMF and follow for a minimum of 2 years. Thirty-nine of the 66 cases received MMF, calcineurin inhibitors, and steroids. In 11 cases daclizumab was added; in 16 daclizumab was added without steroids.
The global survival rate was 91% at 6 months, 89.4% at 1 year, and 87.9% after 2 years. Acute rejection episodes were observed in six patients (9.1%). All episodes responded to corticoids. Toxicity possibly, probably, or partially related to MMF was observed in 35 patients (53%) with definitive suspension required in 13 cases (20%), with dose reduction or temporary suspension in 22 (33%). Hematological toxicity associated with MMF was observed in 12 patients (18%), leading to definitive suspension in two patients (3.03%), temporary suspension in two cases (3.03%), and dose reduction in eight cases (12%). Opportunistic infection was observed in seven cases (10%). Gastrointestinal toxicity was mild and infrequent (five cases, 7.5%).
Regimens containing MMF reduce rejection episodes with high survival rates and low toxicity.