کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6103982 1211134 2013 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Research ArticleAssessment of chronic rejection in liver graft recipients receiving immunosuppression with low-dose calcineurin inhibitors
ترجمه فارسی عنوان
مقاله پژوهشی بررسی تأیید رد پای مزمن در گیرنده های پیوند کبدی که دریافت واکنش های ایمنی بدن را با مهار کننده های کم کالری می کنند
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های گوارشی
چکیده انگلیسی

Background & AimsCalcineurin inhibitors represent the cornerstone immunosuppressants after liver transplantation despite their side effects. As liver graft is particularly well tolerated, low doses may be proposed. The aim of this study was to assess the prevalence of chronic rejection in patients with low calcineurin inhibitors regimen and to compare their characteristics with patients under standard doses.MethodsAll patients with liver transplantation between 1997 and 2004 were divided into two groups. Low-dose patients (n = 57) had tacrolimus baseline levels <5 ng/ml or cyclosporine levels <50 ng/ml at t0 or <100 ng/ml at t + 2 h and were prospectively proposed a liver biopsy, searching for chronic rejection according to Banff criteria. The remaining patients constituted the standard-doses group (n = 40).ResultsAmong the low-dose group, 36 patients in the low-dose group were assessed by biopsy. No chronic rejection was found. Fifty-six percent had only calcineurin inhibitors and 8% received other immunosuppressants only. The median time between liver transplantation and biopsy was 90 months (64-157) and between IS regimen decrease and biopsy was 41 months (11-115). Liver tests were normal in 72% of the patients. Low-dose patients had more often hepatitis B (p = 0.045), less past acute rejection episodes (p = 0.028), and better renal function (p = 0.040). Decrease of calcineurin inhibitors failed in 15% of standard-dose patients without impacting the graft function. In the low-dose group, co-prescription of other immunosuppressants facilitated the decrease (p = 0.051).ConclusionsThe minimization, or even cessation, of calcineurin inhibitors may be an achievable goal in the long term for most of the liver graft recipients.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Hepatology - Volume 59, Issue 6, December 2013, Pages 1223-1230
نویسندگان
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