Efficacy and safety of mycophenolate mofetil as part of induction therapy in liver transplantation.
OBJECTIVE
To report our experience with mycophenolate mofetil (MMF) for induction and maintenance therapy to prevent acute liver transplant rejection.


METHODS
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.


RESULTS
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%).


CONCLUSIONS
Regimens containing MMF reduce rejection episodes with high survival rates and low toxicity.
Pareja-Ciuró
F
F
Hepatobiliary and Pancreatic Surgery and Liver Transplantation Unit, Virgen del Rocío Hospital, Seville, Spain. Felipe.Pareja@terra.es
Díez-Canedo
J Serrano
JS
Gómez-Bravo
M A
MA
García-Gonzalez
I
I
Tamayo-López
M J
MJ
Sousa-Martín
J M
JM
Pascasio-Acevedo
J M
JM
Porras-Lopez
M F
MF
Gavilán-Carrasco
F
F
Bernardos-Rodríguez
A
A
D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008107:Liver Diseases / Q000145:classification / Q000601:surgery*; D016031:Liver Transplantation / Q000276:immunology*; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D012449:Safety; D016019:Survival Analysis; D013997:Time Factors
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid