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. 2011:2011:913094.
doi: 10.1155/2011/913094. Epub 2011 Mar 15.

A Decade of Experience Using mTor Inhibitors in Liver Transplantation

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A Decade of Experience Using mTor Inhibitors in Liver Transplantation

Jeffrey Campsen et al. J Transplant. 2011.

Abstract

Some studies suggest that Sirolimus (SRL) is associated with an increased risk of death in liver transplant recipients compared to treatment with calcineurin inhibitors (CNIs). We compared patients who received SRL or CNI in the first year after liver transplant. Our database included 688 patients who received a liver transplant. The patients were divided into groups. (1) CNI + MPS (mycophenolate sodium) at time of discharge. (2) CNI + MPS at time of discharge; SRL was added within the first 6 months and continued through the first year. (3) CNI + MPS at time of discharge; SRL was added within the first 6 months and discontinued before the first year. (4) SRL as primary immunosuppression. (5) SRL as primary immunosuppression and discontinued before the first year. We used mortality and graft loss as the primary measures of outcome. We also quantified renal function using the change in glomerular filtration rate (GFR), the presence of biopsy proven acute cellular reject (ACR), and steroid-resistant rejection (SRR). There were no significant differences in mortality or graft loss. There was no difference in patient or graft survival. Patients that received SRL as primary immunosuppression had 50% less rejection compared to controls.

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Figures

Figure 1
Figure 1
Graft survival by group. It depicts plots and tables of graft survival across the five groups represented by failure rates per 1000 person-months followup.
Figure 2
Figure 2
Patient survival by group. It depicts plots and tables of patient survival across the five patient categories represented by failure rates per 1000 person-months followup.
Figure 3
Figure 3
GFR (mL/min) outcome (mean). It depicts the glomerular filtration rate (GFR) (mL/min) for the five categories of patients at the times of hospital discharge, 6 months, and 1 year.
Figure 4
Figure 4
Mean Tacrolimus levels at 1 year across all five groups. It depicts mean Tacrolimus levels across all groups at 1 year.

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References

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